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General NPI Number Information
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NPI Number | 1629190848
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Entity Type | Individual
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Provider Name | DEMETRIC MARSH MSW LSW PA LCSW NY
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 60 CHARLES LINDBERGH BLVD SUITE 160 UNIT 4 214
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City | UNIONDALE
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State | NY
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Zip | 11553-3686
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Country | US
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Telephone | 516-227-8284
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Fax |
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Provider Business Mailing Address
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Address Line | 16 LESSING PLACE
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City | FREEPORT
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State | NY
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Zip | 11520
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Country | US
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Telephone | 516-509-5851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW013615
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 044590
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License Number State | NY
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