Healthcare Provider Details

I. General information

NPI: 1780366294
Provider Name (Legal Business Name): LAURA MAINZINGER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 Q ST SE
WASHINGTON DC
20020-5518
US

IV. Provider business mailing address

1157 OATES ST NE UNIT 1
WASHINGTON DC
20002-3823
US

V. Phone/Fax

Practice location:
  • Phone: 202-939-3150
  • Fax:
Mailing address:
  • Phone: 630-518-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200004345
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: