Active NPI
Marissa Dennis, PHD, LP
- Psychoanalyst
- New York, NY
National Provider Identifier
1558876193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- 001010-1
- Practice address
- 1651 3Rd Ave RM 205
New York, NY 10128-3679 - Phone
- (614) 425-4496
- NPI assigned
- Dec 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 001010-1 | NY | Primary |
Addresses
Primary practice location
1651 3Rd Ave RM 205
New York, NY 10128-3679
Mailing address
94 Hauxhurst Ave
Weehawken, NJ 07086-6837
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001010-1 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512432000000",
"number": "1558876193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 HAUXHURST AVE",
"city": "WEEHAWKEN",
"state": "NJ",
"postal_code": "070866837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 3RD AVE RM 205",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283679",
"telephone_number": "614-425-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "MARISSA",
"credential": "PHD, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-05",
"last_updated": "2017-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "001010-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.