Provider Demographics
NPI:1033091319
Name:MARICO, HONIDU (CHW CPS-P DOULA CMC)
Entity type:Individual
Prefix:
First Name:HONIDU
Middle Name:
Last Name:MARICO
Suffix:
Gender:F
Credentials:CHW CPS-P DOULA CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 MAIN ST STE A108
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3060
Mailing Address - Country:US
Mailing Address - Phone:470-336-2149
Mailing Address - Fax:
Practice Address - Street 1:957 MAIN ST STE A108
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3060
Practice Address - Country:US
Practice Address - Phone:470-336-2149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171M00000X, 172V00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker