Provider Demographics
NPI:1922739259
Name:TOPP-BEHRMANN, MARISA RENEE (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:MARISA
Middle Name:RENEE
Last Name:TOPP-BEHRMANN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11255 E FORT RD APT D4
Mailing Address - Street 2:
Mailing Address - City:SUTTONS BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9642
Mailing Address - Country:US
Mailing Address - Phone:517-214-2882
Mailing Address - Fax:
Practice Address - Street 1:3639 CASS RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-9153
Practice Address - Country:US
Practice Address - Phone:231-570-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511111831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical