Provider Demographics
NPI:1437135639
Name:GEBEL-SITTS, MARILYN R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:R
Last Name:GEBEL-SITTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MARILYN
Other - Middle Name:R
Other - Last Name:GEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1091 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6496
Mailing Address - Country:US
Mailing Address - Phone:703-728-4095
Mailing Address - Fax:703-642-6082
Practice Address - Street 1:1091 MARKET ST
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6496
Practice Address - Country:US
Practice Address - Phone:703-728-4095
Practice Address - Fax:703-642-6082
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3000511041C0700X
MD008161041C0700X
VA09040007741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA89 0983 1Medicaid
644616Medicare ID - Type Unspecified