Provider Demographics
NPI:1669593174
Name:WEBB, WENDY MARIAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:MARIAN
Last Name:WEBB
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 1:6123 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4860
Mailing Address - Country:US
Mailing Address - Phone:301-610-8306
Mailing Address - Fax:301-309-2596
Practice Address - Street 1:6123 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4860
Practice Address - Country:US
Practice Address - Phone:301-610-8306
Practice Address - Fax:301-309-2596
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040036911041C0700X
MD119881041C0700X
DCLC500779121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAK5880001Medicare UPIN