Provider Demographics
NPI:1689897688
Name:WILLIAMS, MARILYN FINCH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:FINCH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9870 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3908
Mailing Address - Country:US
Mailing Address - Phone:703-591-9600
Mailing Address - Fax:703-591-9656
Practice Address - Street 1:9870 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3908
Practice Address - Country:US
Practice Address - Phone:703-591-9600
Practice Address - Fax:703-591-9656
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040012021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA586966Medicare ID - Type Unspecified