Individual provider · Type 1 NPI

Marissa Lee Douglas, LMHC

Mental Health Counselor · Brockport, NY

NPI number 1417600982 Active

Practice location

300 West Ave
Brockport, NY 14420-1118

Mailing address

1042 Clarkson Parma Tl Rd
Hilton, NY 14468-9709

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X011838-01 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1417600982

Marissa Lee Douglas, LMHC's National Provider Identifier is 1417600982, issued on Feb 3, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Brockport, NY. The record was last updated on Feb 3, 2022.