Provider Demographics
NPI:1649282781
Name:MARZEN, MARY ANN CATHERINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:CATHERINE
Last Name:MARZEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-2209
Mailing Address - Country:US
Mailing Address - Phone:570-325-4414
Mailing Address - Fax:570-325-8781
Practice Address - Street 1:25 LLANFAIR CIRCLE
Practice Address - Street 2:SENIOR BEHAVIORAL HEALTHCARE GROUP INC.
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-3312
Practice Address - Country:US
Practice Address - Phone:610-649-6769
Practice Address - Fax:610-649-4190
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW004599L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical