Marlena Pique, LCSWC
Individual provider Active NPI Clinical Social Worker · Hagerstown, MD
NPI 1942569181 · NPPES record last updated May 9, 2012
Key facts
- NPI
- 1942569181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 09264 (MD)
- Practice address
- 18714 N Village
Hagerstown, MD 21742-2454 - Phone
- (301) 733-0330
- Fax
- (301) 733-4038
- NPI assigned
- May 9, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Coastal Christian Counseling
Practice addresses (Care Compare)
3025 B Sharpsburg-McCollum Rd
Suite 107
Newnan, GA 30265-6149
Phone (681) 242-7651
4011 Beatline Rd
Suite 12
Long Beach, MS 39560-4138
Phone (681) 242-7651
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220105000076 | MS | Practitioner - Clinical Social Worker | 7719141555 | Reassigns benefits to 1 organization |
| I20230714000769 | GA | Practitioner - Clinical Social Worker | 7719141555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Christian Counseling | Clinical | Current |
Accepting new patients |
| Atlanta Christian Counseling LLC | Clinical | Current |
Accepting new patients |
Locations
4011 Beatline Rd
Ste 12
Long Beach, MS 39560
Phone (228) 800-1445
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 09264 | MD | Yes |
Addresses
Primary practice location
18714 N Village
Hagerstown, MD 21742-2454
Mailing address
13218 Brooklane Dr
Hagerstown, MD 21742-1435
Phone (301) 733-0330
Other providers in Hagerstown, MD
- Jon Alan Pike
- Jessica Lynn Pilgrim
- Santosh Kumar Pillai
- Sue Pinion
- Shivakumar Pinnoju
- Cynthia Pitcher
- Pivots Potential LLC
- Plant the Seeds of Maryland LLC
- Plastic Surgery Services
- Plinth Healthcare LLC
All providers in Hagerstown, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.