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General NPI Number Information
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NPI Number | 1699184838
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Entity Type | Individual
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Provider Name | MARISSA CRYSTAL ENGLEMAN MSW, LCSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 10775 PIONEER TRL STE 215
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City | TRUCKEE
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State | CA
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Zip | 96161-0234
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Country | US
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Telephone | 415-424-4266
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Fax | 415-520-6633
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Provider Business Mailing Address
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Address Line | 8300 ESTERS BLVD STE 900
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City | IRVING
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State | TX
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Zip | 75063-2233
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Country | US
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Telephone | 415-424-4266
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Fax | 415-520-6633
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22739
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61290810
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 127135
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 101866
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License Number State | CA
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