Provider Demographics
NPI:1750157053
Name:PASCARELLA, MARISSA ANN I (LMHC)
Entity type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:ANN
Last Name:PASCARELLA
Suffix:I
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-3410
Mailing Address - Country:US
Mailing Address - Phone:518-270-2646
Mailing Address - Fax:518-270-2707
Practice Address - Street 1:1600 7TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3410
Practice Address - Country:US
Practice Address - Phone:518-270-2646
Practice Address - Fax:518-270-2707
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015016-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health