Provider Demographics
NPI:1497206239
Name:NELLIUS, MARINA PILAR (LCSWC)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:PILAR
Last Name:NELLIUS
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:PILAR
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:MED STAR TOTAL ELDER CARE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2945
Mailing Address - Country:US
Mailing Address - Phone:443-444-6100
Mailing Address - Fax:
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:MED STAR TOTAL ELDER CARE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2945
Practice Address - Country:US
Practice Address - Phone:443-444-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13736104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker