Provider Demographics
NPI:1407119969
Name:ROSENBLUM MAKOVSKY, VARDA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:VARDA
Middle Name:
Last Name:ROSENBLUM MAKOVSKY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HERMLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1646
Mailing Address - Country:US
Mailing Address - Phone:301-593-7294
Mailing Address - Fax:
Practice Address - Street 1:5880 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4821
Practice Address - Country:US
Practice Address - Phone:301-642-6789
Practice Address - Fax:301-328-0910
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD161601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical