Provider Demographics
NPI:1902361025
Name:MARRERO, DENISE (LMSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:MARRERO
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 1:214 PARK LN
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4311
Mailing Address - Country:US
Mailing Address - Phone:917-853-8415
Mailing Address - Fax:
Practice Address - Street 1:1110 SOUTH AVE STE 404
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3411
Practice Address - Country:US
Practice Address - Phone:800-277-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-02
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094103104100000X
NY1007481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker