Provider Demographics
NPI:1346569084
Name:ZAIS, JESSICA E (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:ZAIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:VAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:12501 WILLOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2569
Mailing Address - Country:US
Mailing Address - Phone:301-759-5280
Mailing Address - Fax:301-777-5630
Practice Address - Street 1:12501 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2569
Practice Address - Country:US
Practice Address - Phone:301-759-5280
Practice Address - Fax:301-777-5630
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD139651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical