Provider Demographics
NPI:1467294595
Name:MARBLE, MADISON (MSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:MARBLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 N FAYETTE ST APT 221
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1487
Mailing Address - Country:US
Mailing Address - Phone:202-317-2247
Mailing Address - Fax:
Practice Address - Street 1:1814 N ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2404
Practice Address - Country:US
Practice Address - Phone:218-393-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical