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NPI Code Detail

MEDICARE: MARISOL SAMOL LCSW

MEDICARE:   MARISOL  SAMOL  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker44SL06480800NJ

General Provider Information

NPI Number : 1477114726
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISOL SAMOL LCSW
Provider Business Mailing Address
First Line : PO BOX 495
Second Line :
City : EATONTOWN
State : NJ
Zip : 07724-0495
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 80 SCENIC DR STE 2
Second Line :
City : FREEHOLD
State : NJ
Zip : 07728-5211
Country : US
Telephone Number : 848-231-8429
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2019
Last Update Date : 01/28/2026

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Directions to “ MARISOL SAMOL LCSW” Practice Location

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