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Individual
MS. MARISSA TABAK
Active
Individual
MS. MARISSA TABAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0002853
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09925422
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000237275
—
CO
Enumeration date
07/03/2019
Last updated
02/13/2026
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