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NPI Code Detail

MEDICARE: MARISSA SONG MA, LPCC

MEDICARE: MARISSA SONG MA, LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLPCC.0022186CO

General Provider Information

NPI Number : 1548001738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA SONG MA, LPCC
Provider Business Mailing Address
First Line : 3122 N MARION ST
Second Line :
City : DENVER
State : CO
Zip : 80205-3916
Country : US
Telephone Number : 917-207-4152
Fax Number :
Provider Business Practice Location Address
First Line : 8700 TURNPIKE DR STE 400
Second Line :
City : WESTMINSTER
State : CO
Zip : 80031-7033
Country : US
Telephone Number : 720-316-6564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2024
Last Update Date : 03/02/2026

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