Provider Demographics
NPI:1861544355
Name:HEILFERTY, MARIANNE GM (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:GM
Last Name:HEILFERTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 SPRING TER
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3118
Mailing Address - Country:US
Mailing Address - Phone:703-532-5622
Mailing Address - Fax:
Practice Address - Street 1:501 CHURCH ST NE
Practice Address - Street 2:SUITE 206
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4734
Practice Address - Country:US
Practice Address - Phone:703-969-8533
Practice Address - Fax:703-255-2482
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical