Provider Demographics
NPI:1104816693
Name:AVOY, MARIAN D (LCSW)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:D
Last Name:AVOY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 103 BOX 4827
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09603
Mailing Address - Country:IT
Mailing Address - Phone:632-5667
Mailing Address - Fax:
Practice Address - Street 1:PSC 103 BOX 4827
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09603
Practice Address - Country:IT
Practice Address - Phone:632-5667
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9918901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical