Provider Demographics
NPI:1134924434
Name:MARISSA J BIEDERMAN LLC
Entity type:Organization
Organization Name:MARISSA J BIEDERMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-922-3777
Mailing Address - Street 1:22 BATES RD STE 292
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3280
Mailing Address - Country:US
Mailing Address - Phone:617-922-3777
Mailing Address - Fax:
Practice Address - Street 1:500 GROSSMAN DR STE 1077
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4967
Practice Address - Country:US
Practice Address - Phone:508-299-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health