Provider Demographics
NPI:1720713746
Name:GILBERT, MARISSA F
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:F
Last Name:GILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 N WASHINGTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4517
Mailing Address - Country:US
Mailing Address - Phone:703-942-9745
Mailing Address - Fax:757-585-4466
Practice Address - Street 1:256 N WASHINGTON ST STE 2
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4517
Practice Address - Country:US
Practice Address - Phone:703-942-9745
Practice Address - Fax:757-585-4466
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040181161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical