Healthcare Provider Details

I. General information

NPI: 1346387842
Provider Name (Legal Business Name): JOANNE ZUCCHETTO MSW, LCSW-C, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 RITCHIE HWY SUITE 310
PASADENA MD
21122-1075
US

IV. Provider business mailing address

10114 DAY AVE
SILVER SPRING MD
20910-1040
US

V. Phone/Fax

Practice location:
  • Phone: 410-507-2569
  • Fax:
Mailing address:
  • Phone: 301-588-6065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07072
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: