Provider Demographics
NPI:1417382326
Name:MARBRID, LLC
Entity Type:Organization
Organization Name:MARBRID, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY THERAPIST AND FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-943-7611
Mailing Address - Street 1:131 CHURCH STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181
Mailing Address - Country:US
Mailing Address - Phone:703-943-7611
Mailing Address - Fax:
Practice Address - Street 1:2225 CARMICHAEL DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-3222
Practice Address - Country:US
Practice Address - Phone:703-281-0897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty