Provider Demographics
NPI:1851697692
Name:MARINI, TERISA ANN (MSW, LCSW, CPRP)
Entity Type:Individual
Prefix:MS
First Name:TERISA
Middle Name:ANN
Last Name:MARINI
Suffix:
Gender:F
Credentials:MSW, LCSW, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 GRANBERRY DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5269
Mailing Address - Country:US
Mailing Address - Phone:512-516-2342
Mailing Address - Fax:
Practice Address - Street 1:2605 JONES RD STE E
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2684
Practice Address - Country:US
Practice Address - Phone:512-516-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical