Provider Demographics
NPI:1962511683
Name:RUMMEL, MARCELLA M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:M
Last Name:RUMMEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 RUFFIAN DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-6661
Mailing Address - Country:US
Mailing Address - Phone:540-903-1888
Mailing Address - Fax:540-286-1286
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 301-1
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-903-1888
Practice Address - Fax:540-286-1286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11553247OtherCAQH
VA259791Medicare UPIN
VA7736165Medicare UPIN