Provider Demographics
NPI:1881218618
Name:MARRERO, NICHOLAS J (MSW)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:J
Last Name:MARRERO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5010
Mailing Address - Country:US
Mailing Address - Phone:432-335-8275
Mailing Address - Fax:432-337-0031
Practice Address - Street 1:500 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5010
Practice Address - Country:US
Practice Address - Phone:432-335-8275
Practice Address - Fax:432-337-0031
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker