Provider Demographics
NPI:1013065531
Name:VAN HOVEN, MARCIE ANN
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:ANN
Last Name:VAN HOVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3299 CAMBRIDGE AVE
Mailing Address - Street 2:#8G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3623
Mailing Address - Country:US
Mailing Address - Phone:917-523-8085
Mailing Address - Fax:
Practice Address - Street 1:3299 CAMBRIDGE AVE
Practice Address - Street 2:#8G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3623
Practice Address - Country:US
Practice Address - Phone:917-523-8085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)