Carlson, Marissa

Carlson, Marissa is an individual health care provider with primary practice located at 201 N 8Th St Ste 4 , Saint Maries ID 83861-1869. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Carlson, Marissa can be contacted via phone (208) 597-7639.

Contact Information

Primary practice address
201 N 8Th St Ste 4 Saint Maries ID 83861-1869
Phone: (208) 597-7639
Fax: (208) 717-9450
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LCSW-43558 Idaho
Behavioral Health & Social Service Providers / Social Worker 104100000X 39959 Idaho

Profile Details

NPI number 1124631171
LBN Legal business name Carlson, Marissa
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2020
Last updated Aug 28th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124631171 NPPES
Idaho Other 39959 LICENSE

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