Provider Demographics
NPI:1245393008
Name:CARMODY, MARCIE CHADWICK (LGSW)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:CHADWICK
Last Name:CARMODY
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CONNECTICUT AVE NW APT 143
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5100
Mailing Address - Country:US
Mailing Address - Phone:202-249-9300
Mailing Address - Fax:
Practice Address - Street 1:1012 14TH ST NW STE 1400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3452
Practice Address - Country:US
Practice Address - Phone:202-654-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500781531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical