Active NPI
Marissa Catherine Costantin, LSW
- Social Worker
- Port Charlotte, FL
National Provider Identifier
1215817259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL07043700
- Practice address
- 4161 Tamiami TRL Ste 602
Port Charlotte, FL 33952-9283 - Phone
- (941) 235-2710
- NPI assigned
- Sep 2, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL07043700 | NJ | Primary |
| Social Worker | 104100000X | 32762 | MD |
Addresses
Primary practice location
4161 Tamiami TRL Ste 602
Port Charlotte, FL 33952-9283
Mailing address
12 Dogwood Dr
Barnegat, NJ 08005-3102
Phone (732) 801-5053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32762 | MD | MD | Social Worker |
| 44SL07043700 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1215817259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 DOGWOOD DR",
"city": "BARNEGAT",
"state": "NJ",
"postal_code": "080053102",
"telephone_number": "732-801-5053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4161 TAMIAMI TRL STE 602",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339529283",
"telephone_number": "941-235-2710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANTIN",
"first_name": "MARISSA",
"middle_name": "CATHERINE",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-02",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL07043700",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "32762",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.