Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marissa Ann Widener, LPC

Individual provider Mental Health Counselor · NPI 1104525880

Marissa Ann Widener, LPC is a Mental Health Counselor in Phoenix, Arizona. Qualified in 2022, 4 years ago. Works from 2 locations. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2023
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806
Phone: (602) 230-7373
Fax: (602) 682-7455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2211 E Highland Ave Ste 205, Phoenix, AZ 85016-4834 — (888) 661-2742

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-24585 (AZ)
Mental Health Counselor Taxonomy 101YM0800X · Licence LPC-24585 (AZ)

Record details

NPI number1104525880
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedMarch 1, 2023
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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