Provider Demographics
NPI:1891586228
Name:PYCHA, MARISSA (MSW)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:PYCHA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 GERMAN CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3642
Mailing Address - Country:US
Mailing Address - Phone:301-706-2804
Mailing Address - Fax:
Practice Address - Street 1:2972 PENWICK LN STE 101
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-2728
Practice Address - Country:US
Practice Address - Phone:301-706-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD33091104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker