Marisa Ana Lare, LMSW
Individual provider Active NPI Social Worker · Jefferson, MD
NPI 1467150417 · NPPES record last updated Jul 3, 2024
Key facts
- NPI
- 1467150417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 28633 (MD)
- Practice address
- 4014J Mountville Rd Unit a
Jefferson, MD 21755-7713 - Phone
- (240) 986-1001
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28633 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marisa Lare Therapy LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 28633 | MD | Yes |
Addresses
Primary practice location
4014J Mountville Rd Unit a
Jefferson, MD 21755-7713
Mailing address
4014J Mountville Rd Unit a
Jefferson, MD 21755-7713
Other providers in Jefferson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.