Healthcare Provider Details

I. General information

NPI: 1952135121
Provider Name (Legal Business Name): ANNA ZIPPELLI LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15505 CARRS MILL RD
WOODBINE MD
21797-8005
US

IV. Provider business mailing address

8894 STANFORD BLVD STE 103
COLUMBIA MD
21045-5161
US

V. Phone/Fax

Practice location:
  • Phone: 347-266-8532
  • Fax:
Mailing address:
  • Phone: 347-266-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP15134
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: