Provider Demographics
NPI:1184389488
Name:MARSH, ANA M (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:MARSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:M
Other - Last Name:ROLDAN-MARSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:32A FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1227
Mailing Address - Country:US
Mailing Address - Phone:917-803-1258
Mailing Address - Fax:
Practice Address - Street 1:32A FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1227
Practice Address - Country:US
Practice Address - Phone:347-918-5456
Practice Address - Fax:315-816-4837
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0736501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical