Provider Demographics
NPI:1952855561
Name:TRIEBSEE, MARITA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARITA
Middle Name:
Last Name:TRIEBSEE
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 1:665 PELHAM PKWY N
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8068
Mailing Address - Country:US
Mailing Address - Phone:718-519-8326
Mailing Address - Fax:718-881-8714
Practice Address - Street 1:665 PELHAM PKWY N
Practice Address - Street 2:SUITE 402
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8068
Practice Address - Country:US
Practice Address - Phone:718-519-8326
Practice Address - Fax:718-881-8714
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096566104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker