MARISSA DECESARIS (NPI# 1427569706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427569706 |
| Entity Type | Individual |
| Full Name | MARISSA DECESARIS |
| Credential | PMHNP |
| Practice Address |
3300 Henry Ave Philadelphia PA 19129-1121 |
| Mailing Address |
700 S 17th St Apt 201n Philadelphia PA 19146-1939 |
| Practice Telephone | 2152542069 |
| Mailing Telephone | 6092307534 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP017981 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 Elwyn Rd, Media, PA 190634622 | 6108912000 | |
| 4040 Market St, Philadelphia, PA 191043003 | 2158955500 |
| Street Address |
3300 HENRY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19129-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396361978 | Amanda Marie Mastronardi | Social Worker | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2020-06-19 |
| 1467085092 | Yuriko Matsuo | Nurse Practitioner | 3300 Henry Ave, Philadelphia, PA 19129 | 2020-02-21 |
| 1518590249 | Joshua Ross Burton | Counselor | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2020-02-21 |
| 1831722164 | Tinika Rhonda Stubbs | Health Educator | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2020-02-14 |
| 1689207037 | Kathleen Giosso | Health Educator | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2020-02-13 |
| 1811556723 | Summer L Fowlkes | Behavioral Analyst | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2019-06-13 |
| 1265996938 | Devereux Foundation | Clinic/Center | 3300 Henry Ave, Philadelphia, PA 19129-1141 | 2019-01-28 |
| 1578062493 | Belmont Behavioral Hospital, LLC | Community/Behavioral Health | 3300 Henry Ave, Philadelphia, PA 19129 | 2018-02-06 |
| 1396250833 | Community Services of Devereux | Community/Behavioral Health | 3300 Henry Ave, Philadelphia, PA 19129-1121 | 2017-12-06 |
| 1124531520 | Robert Edison Slawinski | Psychologist | 3300 Henry Ave, Philadelphia, PA 19129-1121 | 2017-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982243754 | Margaret Brown | Social Worker | Sherman Mills 3502 Scott's Lane, Building 16, Philadelphia, PA 19129 | 2019-12-27 |
| 1518325760 | Care365 Inc | Case Management | 3507 Scotts Ln, Ste. 1923, Philadelphia, PA 19129 | 2016-02-03 |
| 1144698408 | Raymond C Nwaneri | Nurse Practitioner | 3301 Scotts Lane, Haven Behavioral Hospital, Philadelphia, PA 19129 | 2015-09-03 |
| 1659748432 | Donna S. Wolf | Social Worker | 3302 Tilden Street, Philadelphia, PA 19129 | 2015-08-27 |
| 1891066619 | Melissa Sayer | Advanced Practice Midwife | 2450 W. Hunting Park Ave, Temple University Health System, Philadelphia, PA 19129 | 2012-01-25 |
| 1154604007 | Keystone Psychological Associates | Clinic/Center | 3502 Scotts Lane, Building 1 Suite 114, Philadelphia, PA 19129 | 2011-09-27 |
| 1174754618 | Clarence B Iszard Jr. | Counselor | 3246 North Bailey Street, Philadelphia, PA 19129 | 2009-07-31 |
| 1487816708 | St.chris Care At Northeast Pediatrics, LLC | Pediatrics | One Falls Center, 3300 Henry Avenue, 4th Floor, Philadelphia, PA 19129 | 2008-06-27 |
| 1740400845 | Sharon L. Young | Psychologist | 3205 Defense Terrace, Abbottsford Family Practice & Counseling, Philadelphia, PA 19129 | 2007-04-30 |
| 1043355621 | Donald Herman Silverman | Dentist | 3405 Warden Drive, Philadelphia, PA 19129 | 2007-02-21 |
| Find all providers in zip 19129 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1336410851 | Justin Egoville | Nurse Practitioner | 80001 State Rd., Mhm Correctional Services, Mod II, Philadelphia, PA 19136-0000 | 2012-01-13 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19129 |
Please comment or provide details below to improve the information on MARISSA DECESARIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.