1437135639 NPI number — MRS. MARILYN R GEBEL-SITTS LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437135639 NPI number — MRS. MARILYN R GEBEL-SITTS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEBEL-SITTS
Provider First Name:
MARILYN
Provider Middle Name:
R
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GEBEL
Provider Other First Name:
MARILYN
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437135639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4705 PICKETT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22032-2027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-728-4095
Provider Business Mailing Address Fax Number:
703-642-6082

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4705 PICKETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22032-2027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-728-4095
Provider Business Practice Location Address Fax Number:
703-642-6082
Provider Enumeration Date:
12/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  00816 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LC300051 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 0904000774 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 89 0983 1 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".