Provider Demographics
NPI:1508296955
Name:VIZZINI, JOANNE F (PHD, LCPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:F
Last Name:VIZZINI
Suffix:
Gender:F
Credentials:PHD, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10715 CHARTER DRIVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2871
Mailing Address - Country:US
Mailing Address - Phone:443-831-1948
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1847
Practice Address - Country:US
Practice Address - Phone:443-831-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC1091OtherLCPC