Provider Demographics
NPI:1770549669
Name:CHEW, MARION (PHD)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:CHEW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W BROAD ST
Mailing Address - Street 2:305
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3220
Mailing Address - Country:US
Mailing Address - Phone:703-533-3302
Mailing Address - Fax:703-237-2083
Practice Address - Street 1:701 W BROAD ST
Practice Address - Street 2:305
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3220
Practice Address - Country:US
Practice Address - Phone:703-533-3302
Practice Address - Fax:703-237-2083
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002478103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA231416OtherANTHEM
VA89130006OtherCAREFIRST BCBS
VA293988OtherAMERIGROUP CORPORATION
VA7514498OtherAETNA BEHAVIORAL
VA00A095C64Medicare ID - Type Unspecified