Provider Demographics
NPI:1902103021
Name:MARSELLA, JEFFREY ARON (MA, CAGS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ARON
Last Name:MARSELLA
Suffix:
Gender:M
Credentials:MA, CAGS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 SOCKANOSSET CROSS RD STE 307
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5559
Mailing Address - Country:US
Mailing Address - Phone:401-749-9358
Mailing Address - Fax:
Practice Address - Street 1:95 SOCKANOSSET CROSS RD STE 307
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5559
Practice Address - Country:US
Practice Address - Phone:401-749-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health