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

Marissa Lee Lodge

Individual provider Behavior Technician · NPI 1467986331

Marissa Lee Lodge is a Behavior Technician in Rockford, Illinois. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
2

Practice location Address checks out

8616 Northern Ave
Rockford, IL 61107-5309
Phone: (815) 332-8003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1467986331
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 17, 2017
Last updated in NPPESAugust 3, 2018
Mailing address1021 N Mulford Rd, Rockford, IL 61107-3877

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