Provider Demographics
NPI:1942913710
Name:YERKES, MARISA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:YERKES
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 1:2565 S PATTERSON
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7564
Mailing Address - Country:US
Mailing Address - Phone:602-884-0278
Mailing Address - Fax:
Practice Address - Street 1:1206 E WARNER RD STE 118
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3133
Practice Address - Country:US
Practice Address - Phone:480-269-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-7692T1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical