Healthcare Provider Details

I. General information

NPI: 1033880158
Provider Name (Legal Business Name): MARIA VELASCO BERTERO LCSWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 BRIGHTSEAT RD
LANDOVER MD
20785-4725
US

IV. Provider business mailing address

880 NEW JERSEY AVE SE APT 1135
WASHINGTON DC
20003-3770
US

V. Phone/Fax

Practice location:
  • Phone: 301-333-2980
  • Fax:
Mailing address:
  • Phone: 856-425-0027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28827
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200001253
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: