Provider Demographics
NPI:1386143444
Name:MOBLEY, MARIA ANTOINETTE (MSW, LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTOINETTE
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:MSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 CRAIN HWY # 382
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1303
Mailing Address - Country:US
Mailing Address - Phone:240-548-3808
Mailing Address - Fax:
Practice Address - Street 1:1933 MONTANA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1817
Practice Address - Country:US
Practice Address - Phone:240-548-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional