Provider Demographics
NPI:1942032487
Name:COLLING, MARISSA (LMSW)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:COLLING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32222 MARYLAND ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3814
Mailing Address - Country:US
Mailing Address - Phone:734-895-5883
Mailing Address - Fax:
Practice Address - Street 1:23332 ORCHARD LAKE RD STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3280
Practice Address - Country:US
Practice Address - Phone:586-310-8158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010993411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical