Healthcare Provider Details

I. General information

NPI: 1093629107
Provider Name (Legal Business Name): MARISSA ZINDELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5506 CONNECTICUT AVE NW
WASHINGTON DC
20015-2600
US

IV. Provider business mailing address

4114 CHESAPEAKE ST NW
WASHINGTON DC
20016-4608
US

V. Phone/Fax

Practice location:
  • Phone: 202-455-0706
  • Fax:
Mailing address:
  • Phone: 771-202-1753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50081336
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: