Provider Demographics
NPI:1134782071
Name:PARISE, MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:PARISE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 LACEY RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1051
Mailing Address - Country:US
Mailing Address - Phone:732-592-3794
Mailing Address - Fax:732-228-8418
Practice Address - Street 1:1044 LACEY RD STE 1A
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1051
Practice Address - Country:US
Practice Address - Phone:732-592-3794
Practice Address - Fax:732-228-8418
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058485001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical