Provider Demographics
NPI:1831926708
Name:COUNSELING WITH MARISSA, LLC
Entity type:Organization
Organization Name:COUNSELING WITH MARISSA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-412-4638
Mailing Address - Street 1:24 DOWD AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2480
Mailing Address - Country:US
Mailing Address - Phone:860-990-2942
Mailing Address - Fax:
Practice Address - Street 1:111 MAIN ST # 2WA
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3182
Practice Address - Country:US
Practice Address - Phone:860-412-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty