Healthcare Provider Details

I. General information

NPI: 1376112862
Provider Name (Legal Business Name): MARLI LEAH SARECKY LCSW, LCSWC, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11904 DARNESTOWN RD STE F
GAITHERSBURG MD
20878-3202
US

IV. Provider business mailing address

7700 OLD GEORGETOWN RD STE 675
BETHESDA MD
20814-6100
US

V. Phone/Fax

Practice location:
  • Phone: 301-835-2732
  • Fax:
Mailing address:
  • Phone: 301-785-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904016522
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27362
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003223
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: