1295811644 NPI number — MISS MARY LYNNE ZIEGLER LCSW-C

Table of content: MISS MARY LYNNE ZIEGLER LCSW-C (NPI 1295811644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295811644 NPI number — MISS MARY LYNNE ZIEGLER LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIEGLER
Provider First Name:
MARY
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LCSW-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295811644
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 973
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21158-0973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-848-5785
Provider Business Mailing Address Fax Number:
410-848-5629

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 N COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21157-5110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-821-8989
Provider Business Practice Location Address Fax Number:
866-664-2949
Provider Enumeration Date:
10/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW016995 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 04766 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0455911 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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