Provider Demographics
NPI:1639280068
Name:OLAFSSON, MARISA C (LMSW)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:C
Last Name:OLAFSSON
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 1:833 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1185
Mailing Address - Country:US
Mailing Address - Phone:248-229-1659
Mailing Address - Fax:
Practice Address - Street 1:833 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1185
Practice Address - Country:US
Practice Address - Phone:248-229-1659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI68010861851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical