Healthcare Provider Details

I. General information

NPI: 1518821818
Provider Name (Legal Business Name): MARINA B ROSS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 MARTIN LUTHER KING JR AVE SW STE A13
WASHINGTON DC
20032-4880
US

IV. Provider business mailing address

13002 SALFORD TER
UPPER MARLBORO MD
20772-6130
US

V. Phone/Fax

Practice location:
  • Phone: 202-318-0179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLG200004271
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: