National Provider Identifier
Marissa Lee Douglas, LMHC
Marissa Lee Douglas, LMHC is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Brockport, NY and a listed phone number of (585) 637-3905.
Profile Overview
- NPI
- 1417600982
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- February 03, 2022
- Last Updated
- February 03, 2022
Practice Location
- 300 West Ave
- Brockport, NY 14420-1118
Phone: (585) 637-3905
Mailing Address
- 1042 Clarkson Parma Tl RD
- Hilton, NY 14468-9709
Specialties
- Mental Health Counselor (101YM0800X)
Endpoints
- mdouglas@oochc.org
Direct Messaging Address | Brockport, NY 14420
Full Record
- NPI
- 1417600982
- Entity Type
- Individual
- Last Name
- Douglas
- First Name
- Marissa
- Middle Name
- Lee
- Credential
- LMHC
- Mailing Street Address
- 1042 Clarkson Parma Tl RD
- Mailing City
- Hilton
- Mailing State
- NY
- Mailing ZIP Code
- 14468-9709
- Mailing Country
- US
- Mailing Phone
- (585) 749-3274
- Practice Street Address
- 300 West Ave
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-1118
- Practice Country
- US
- Practice Phone
- (585) 637-3905
- Enumeration Date
- February 03, 2022
- Last Updated
- February 03, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 03, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)