Provider Demographics
NPI:1093907933
Name:PRICE, MARILYN DENISE GRAYNED (LCSW-C, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:DENISE GRAYNED
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 CASSIDY CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3761
Mailing Address - Country:US
Mailing Address - Phone:240-375-6512
Mailing Address - Fax:
Practice Address - Street 1:10333 CASSIDY CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3761
Practice Address - Country:US
Practice Address - Phone:240-375-6512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500782221041C0700X
MD128791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical