Pena, Marissa Rose

Pena, Marissa Rose is an sole proprietor health care provider with primary practice located at 1060 W Perimeter Rd , Jb Andrews MD 20762-6602. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Pena, Marissa Rose can be contacted via phone (240) 857-7186.

Contact Information

Primary practice address
1060 W Perimeter Rd Jb Andrews MD 20762-6602
Phone: (240) 857-7186
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11716 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 27077 Maryland
Behavioral Health & Social Service Providers / Clinical 1041C0700X C-07302 New Mexico

Profile Details

NPI number 1588869739
LBN Legal business name Pena, Marissa Rose
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2007
Last updated May 23rd, 2021 - about 5 years ago

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 1588869739 NPPES
Maryland Other LCSW-C CLINICAL SOCIAL WORKER
Maryland Other LCDC CLINICAL SOCIAL WORKER
Maryland Other LCSW CLINICAL SOCIAL WORKER

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