Provider Demographics
NPI:1346387842
Name:ZUCCHETTO, JOANNE (MSW, LCSW-C, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:ZUCCHETTO
Suffix:
Gender:F
Credentials:MSW, LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10114 DAY AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1040
Mailing Address - Country:US
Mailing Address - Phone:301-588-6065
Mailing Address - Fax:
Practice Address - Street 1:8028 RITCHIE HWY
Practice Address - Street 2:SUITE 310
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1075
Practice Address - Country:US
Practice Address - Phone:410-507-2569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQW-22Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER