Healthcare Provider Details

I. General information

NPI: 1710644067
Provider Name (Legal Business Name): GARRETT MARPLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GARRETT RHODES MARPLE LCSW-C

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14403 WOODCREST DR
ROCKVILLE MD
20853-2336
US

IV. Provider business mailing address

4021 38TH AVE N
ST PETERSBURG FL
33713-1232
US

V. Phone/Fax

Practice location:
  • Phone: 301-250-6127
  • Fax:
Mailing address:
  • Phone: 301-250-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30731
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: