Provider Demographics
NPI:1508602913
Name:MARRARA, JAMIE (MHC-LP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MARRARA
Suffix:
Gender:X
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 HALSEY ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1015
Mailing Address - Country:US
Mailing Address - Phone:918-693-5751
Mailing Address - Fax:
Practice Address - Street 1:113 UNIVERSITY PLACE
Practice Address - Street 2:11TH FLOOR, OFFICES A AND B
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:929-777-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health