MEDICARE: CHERYL ZANDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701010112	VA

General Provider Information

NPI Number	:	1487095246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ZANDT

Provider Business Mailing Address
First Line	:	475 K ST NW UNIT 606
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-5260
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 N WASHINGTON ST STE 100
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3538
Country	:	US
Telephone Number	:	202-594-8982
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2013
Last Update Date	:	12/01/2020

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