Provider Demographics
NPI:1437335692
Name:LOGAN, VICTORIA ZEBRAUSKAS (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ZEBRAUSKAS
Last Name:LOGAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SISTER PIERRE DR
Mailing Address - Street 2:SUITE 407
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7516
Mailing Address - Country:US
Mailing Address - Phone:443-279-2000
Mailing Address - Fax:443-279-2004
Practice Address - Street 1:120 SISTER PIERRE DR
Practice Address - Street 2:SUITE 407
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7516
Practice Address - Country:US
Practice Address - Phone:443-279-2000
Practice Address - Fax:443-279-2004
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional