Healthcare Provider Details

I. General information

NPI: 1447189881
Provider Name (Legal Business Name): MARILENNIS GISSELLE WEIS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARILENNIS CRUZ TAPIA

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12774 WISTERIA DR UNIT 1038
GERMANTOWN MD
20875-7555
US

IV. Provider business mailing address

12774 WISTERIA DR UNIT 1038
GERMANTOWN MD
20875-7555
US

V. Phone/Fax

Practice location:
  • Phone: 202-417-8820
  • Fax:
Mailing address:
  • Phone: 202-417-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24030
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: