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NPI Code Detail

MEDICARE: MS. MARISELA BOLANOS

MEDICARE: MS. MARISELA BOLANOS
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
11041C0700XClinical Social Worker150118194IL
21041C0700XClinical Social WorkerP023605NC

General Provider Information

NPI Number : 1780557959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARISELA BOLANOS
Provider Business Mailing Address
First Line : 2 WISCONSIN CIR STE 700
Second Line :
City : CHEVY CHASE
State : MD
Zip : 20815-7007
Country : US
Telephone Number : 202-436-2536
Fax Number :
Provider Business Practice Location Address
First Line : 2 WISCONSIN CIR STE 700
Second Line :
City : CHEVY CHASE
State : MD
Zip : 20815-7007
Country : US
Telephone Number : 202-436-2536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2025
Last Update Date : 05/21/2026

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Directions to “ MS. MARISELA BOLANOS ” Practice Location

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