MEDICARE: MARISSA PINTO

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
1	101Y00000X	Counselor		GA

General Provider Information

NPI Number	:	1588378731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA PINTO

Provider Business Mailing Address
First Line	:	13525 BLAKMARAL LN
Second Line	:
City	:	MILTON
State	:	GA
Zip	:	30004-3400
Country	:	US
Telephone Number	:	678-628-4505
Fax Number	:

Provider Business Practice Location Address
First Line	:	13525 BLAKMARAL LN
Second Line	:
City	:	MILTON
State	:	GA
Zip	:	30004-3400
Country	:	US
Telephone Number	:	678-628-4505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	06/13/2026

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Directions to “ MARISSA PINTO ” Practice Location

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