Provider Demographics
NPI:1346590551
Name:KEILSON, MARISSA (MSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:KEILSON
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 TOWER OAKS BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4280
Mailing Address - Country:US
Mailing Address - Phone:240-200-5401
Mailing Address - Fax:
Practice Address - Street 1:8607 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4324
Practice Address - Country:US
Practice Address - Phone:410-336-6513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD180541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical