Provider Demographics
NPI:1285785329
Name:MESSINA, MARILYN (LISW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:MESSINA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 PARK MEADOW RD.
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:614-882-9338
Mailing Address - Fax:614-882-3401
Practice Address - Street 1:774 PARK MEADOW RD.
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-882-9338
Practice Address - Fax:614-882-3401
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00098791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical