Healthcare Provider Details

I. General information

NPI: 1013840149
Provider Name (Legal Business Name): MARISA SCHELHORN LICENSED CLINICAL SOCIAL WORKER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CHERYL LN N
FARMINGDALE NY
11735-4407
US

IV. Provider business mailing address

6 CHERYL LN N
FARMINGDALE NY
11735-4407
US

V. Phone/Fax

Practice location:
  • Phone: 516-477-7838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MARISA MARIE SCHELHORN
Title or Position: OWNER
Credential: LCSW
Phone: 516-477-7838