Provider Demographics
NPI:1417714866
Name:LOMBARDO, MARRIAH TESS (LCSW)
Entity Type:Individual
Prefix:
First Name:MARRIAH
Middle Name:TESS
Last Name:LOMBARDO
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 1:14018 VALLEYFIELD DR APT 4
Mailing Address - Street 2:
Mailing Address - City:ASPEN HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5781
Mailing Address - Country:US
Mailing Address - Phone:203-215-7924
Mailing Address - Fax:
Practice Address - Street 1:509 QUINCE ORCHARD RD # 222
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1435
Practice Address - Country:US
Practice Address - Phone:203-215-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker