Provider Demographics
NPI:1225920549
Name:GSPONER, MARILYN SABINE (LCSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:SABINE
Last Name:GSPONER
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 1:2948 TOPSIDE RD UNIT 190
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-3871
Mailing Address - Country:US
Mailing Address - Phone:323-377-1403
Mailing Address - Fax:
Practice Address - Street 1:2948 TOPSIDE RD UNIT 190
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:TN
Practice Address - Zip Code:37777-3871
Practice Address - Country:US
Practice Address - Phone:323-377-1403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040184541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical