Provider Demographics
NPI:1861814725
Name:COMO, MARISA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:
Last Name:COMO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14245 58TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5310
Mailing Address - Country:US
Mailing Address - Phone:718-445-4222
Mailing Address - Fax:718-353-6942
Practice Address - Street 1:14245 58TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5310
Practice Address - Country:US
Practice Address - Phone:718-445-4222
Practice Address - Fax:718-353-6942
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075542104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker