Provider Demographics
NPI:1700254950
Name:BLEIWEIS, ROSE (LGSW)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:BLEIWEIS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 RIPLEY ST APT 705
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-7456
Mailing Address - Country:US
Mailing Address - Phone:301-461-4619
Mailing Address - Fax:
Practice Address - Street 1:3300 OLNEY SANDY SPRING RD STE 340
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3306
Practice Address - Country:US
Practice Address - Phone:240-389-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD208391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical