Provider Demographics
NPI:1699049346
Name:WILMOT, MARCIA ANNMARIE (MA, NCC, LCPC)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:ANNMARIE
Last Name:WILMOT
Suffix:
Gender:F
Credentials:MA, NCC, LCPC
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:ANNMARIE
Other - Last Name:WILMOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, NCC, LCPC
Mailing Address - Street 1:3100 QUARTET LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6823
Mailing Address - Country:US
Mailing Address - Phone:301-890-4210
Mailing Address - Fax:301-890-3766
Practice Address - Street 1:5124 DORSEY HALL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7870
Practice Address - Country:US
Practice Address - Phone:301-890-4210
Practice Address - Fax:301-890-3766
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional