Healthcare Provider Details

I. General information

NPI: 1083397319
Provider Name (Legal Business Name): JAMES H MARRONE LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 N MINNESOTA ST
CARSON CITY NV
89703-3850
US

IV. Provider business mailing address

406 E ADAMS ST APT B
CARSON CITY NV
89706-3045
US

V. Phone/Fax

Practice location:
  • Phone: 445-735-0775
  • Fax:
Mailing address:
  • Phone: 775-671-6187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9171-M
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-2299
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: