Provider Demographics
NPI:1427560085
Name:ZDANOWICZ, BRET RICHARD (LCSW)
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:RICHARD
Last Name:ZDANOWICZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VARNUM STREET, NE
Mailing Address - Street 2:ST. CATHERINE HALL/1ST FL/RM 102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2104
Mailing Address - Country:US
Mailing Address - Phone:202-854-7881
Mailing Address - Fax:202-854-7491
Practice Address - Street 1:1150 VARNUM ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2104
Practice Address - Country:US
Practice Address - Phone:202-854-7881
Practice Address - Fax:202-854-7491
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500815091041C0700X
DCLG50080757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker