Healthcare Provider Details

I. General information

NPI: 1568327955
Provider Name (Legal Business Name): STELLA MIRIAM MARSH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E 85TH ST APT 4A
NEW YORK NY
10028-3117
US

IV. Provider business mailing address

216 E 85TH ST APT 4A
NEW YORK NY
10028-3117
US

V. Phone/Fax

Practice location:
  • Phone: 888-604-6776
  • Fax:
Mailing address:
  • Phone: 888-604-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SLO7334900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127843
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: