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NPI Code Detail

MEDICARE: MARLEY JEROME-FEATHERSON LCSW-C

MEDICARE: MARLEY JEROME-FEATHERSON LCSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor10518MD
21041C0700XClinical Social Worker10518MD
31041S0200XSchool Social WorkerPPS-567827VA

General Provider Information

NPI Number : 1174064232
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLEY JEROME-FEATHERSON LCSW-C
Provider Business Mailing Address
First Line : 610 PROFESSIONAL DR
Second Line : SUITE 255
City : GAITHERSBURG
State : MD
Zip : 20879-3413
Country : US
Telephone Number : 240-396-5155
Fax Number :
Provider Business Practice Location Address
First Line : 610 PROFESSIONAL DR STE 255
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20879-3463
Country : US
Telephone Number : 240-683-6202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2017
Last Update Date : 04/24/2026

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