Provider Demographics
NPI:1598492035
Name:STEVEN, MARISSA RACHEL MIARA (LPCC)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:RACHEL MIARA
Last Name:STEVEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:RACHEL
Other - Last Name:MIARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APCC
Mailing Address - Street 1:4750 LINCOLN BLVD APT 418
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-9305
Mailing Address - Country:US
Mailing Address - Phone:845-826-5686
Mailing Address - Fax:
Practice Address - Street 1:4750 LINCOLN BLVD APT 418
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-9305
Practice Address - Country:US
Practice Address - Phone:845-826-5686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional