Healthcare Provider Details

I. General information

NPI: 1831933340
Provider Name (Legal Business Name): INNA ZUSMAN LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 CORPORATE BLVD STE 270
ROCKVILLE MD
20850-3856
US

IV. Provider business mailing address

18507 COUNTRY MEADOW RD
BOYDS MD
20841-4335
US

V. Phone/Fax

Practice location:
  • Phone: 301-944-9065
  • Fax:
Mailing address:
  • Phone: 240-702-4263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: