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General NPI Number Information
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NPI Number | 1093477309
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Entity Type | Organization
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Legal Business Name | ZEN PSYCHOLOGICAL CENTER
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 11 BYTE CT STE C
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City | FREDERICK
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State | MD
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Zip | 21702-8718
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Country | US
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Telephone | 240-457-9194
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Fax |
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Provider Business Mailing Address
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Address Line | 11 BYTE CT STE C
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City | FREDERICK
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State | MD
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Zip | 21702-8718
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Country | US
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Telephone | 301-246-0206
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY GOFF
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Credential | LCSW-C
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Telephone | 240-687-8507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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