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General NPI Number Information
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NPI Number | 1063771558
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Entity Type | Individual
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Provider Name | ROBERT MATTHEW ZENDLE LCPC, LCADC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 604 WESTGATE RD
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City | ABERDEEN
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State | MD
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Zip | 21001-1625
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Country | US
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Telephone | 410-989-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 604 WESTGATE RD
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City | ABERDEEN
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State | MD
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Zip | 21001-1625
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Country | US
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Telephone | 410-989-1122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA1786
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC3571
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License Number State | MD
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