Organization Active NPI

Marissa Holsten PLLC

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1255188173
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MARISSA HOLSTEN PLLC
Practice address
3326 Durham Chapel Hill Blvd Ste 230a
Durham, NC 27707-6266
Phone
(919) 443-5141
NPI assigned
Apr 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marissa HolstenNPI 1811284805
Title
Owner/Therapist
Phone
(845) 661-1663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3326 Durham Chapel Hill Blvd Ste 230a
Durham, NC 27707-6266

Mailing address

2316 Oriole Dr
Durham, NC 27707-5427
Phone (845) 661-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240816000904 NC Part B Supplier - Clinic/Group Practice 7618415019 Receives reassigned benefits from 1 practitioner
Practice locations: Durham, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1255188173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 ORIOLE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075427",
            "telephone_number": "845-661-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 DURHAM CHAPEL HILL BLVD STE 230A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076266",
            "telephone_number": "919-443-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISSA HOLSTEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "HOLSTEN",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "845-661-1663"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.