Provider Demographics
NPI:1245349893
Name:MARINO, DEBORAH JANETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JANETTE
Last Name:MARINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DEBBIE
Other - Middle Name:JANETTE
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8700 US HIGHWAY 380 STE 517
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2661
Mailing Address - Country:US
Mailing Address - Phone:866-832-1708
Mailing Address - Fax:888-789-4391
Practice Address - Street 1:8700 US HIGHWAY 380 STE 517
Practice Address - Street 2:
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-2661
Practice Address - Country:US
Practice Address - Phone:866-832-1708
Practice Address - Fax:888-789-4391
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS238911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1856965-02Medicaid
TX185696503Medicaid