Provider Demographics
NPI:1194358564
Name:REIMANN, MARIE RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:RENEE
Last Name:REIMANN
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 1:4423 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5601
Mailing Address - Country:US
Mailing Address - Phone:703-344-4796
Mailing Address - Fax:
Practice Address - Street 1:210B COMMERCE ST
Practice Address - Street 2:
Practice Address - City:OCCOQUAN
Practice Address - State:VA
Practice Address - Zip Code:22125-7707
Practice Address - Country:US
Practice Address - Phone:703-344-4796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040106131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical