Marissa Lee Dietz
Individual provider Active NPI Social Worker · Mountain Home, TN
NPI 1760355408 · NPPES record last updated Sep 29, 2025
Key facts
- NPI
- 1760355408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 150.116935 (IL)
- Practice address
- PO Box 4000
Mountain Home, TN 37684-4000 - Phone
- (423) 926-1171
- Fax
- (423) 979-3005
- NPI assigned
- Sep 29, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 150.116935 | IL | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.116935 | IL | Yes |
Addresses
Primary practice location
PO Box 4000
Mountain Home, TN 37684-4000
Mailing address
PO Box 4000
Mountain Home, TN 37684-4000
Phone (423) 926-1171
Other providers in Mountain Home, TN
- Megan Day
- Donita Lynne Denton
- Mark Alan Depew
- Melissa Dawn Deprimo
- Keith Joseph Devos
- Joseph Cramer Difrancesco
- Harold Dexter Dillon III
- Mariah Ann Dishner
- Savanah Leigh Dishner
- Amanda Dobbs
All providers in Mountain Home, TN · Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2025. 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.