Provider Demographics
NPI:1871885392
Name:SAPHIRSTEIN, MARISSA EDEN (LMSW)
Entity type:Individual
Prefix:MISS
First Name:MARISSA
Middle Name:EDEN
Last Name:SAPHIRSTEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BELLMORE RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3434
Mailing Address - Country:US
Mailing Address - Phone:516-316-5808
Mailing Address - Fax:
Practice Address - Street 1:155 BELLMORE RD
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3434
Practice Address - Country:US
Practice Address - Phone:516-316-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083552-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker