Provider Demographics
NPI:1326083353
Name:CHOPPIN, MARIE C
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:CHOPPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 PENTENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3525
Mailing Address - Country:US
Mailing Address - Phone:301-625-9102
Mailing Address - Fax:866-445-3249
Practice Address - Street 1:8830 CAMERON CT
Practice Address - Street 2:SUITE 101
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4114
Practice Address - Country:US
Practice Address - Phone:301-625-9102
Practice Address - Fax:866-445-3249
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE491636Medicare ID - Type Unspecified
DC491636Medicare ID - Type Unspecified