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

Individual provider Clinical Social Worker · NPI 1437203320

Mrs. Marisa Boulukos, LCSWR is a Clinical Social Worker in Massapequa, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
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Practice location Address checks out

75 Grand Ave
Massapequa, NY 11758-4905
Phone: (516) 799-3202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R042317-1 (NY)

Record details

NPI number1437203320
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWR
Sole proprietorYes
NPI enumeratedJanuary 22, 2007
Last updated in NPPESJuly 8, 2007

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