Provider Demographics
NPI:1558636134
Name:ZIMONJIC, NEBOJSA V (MS, LGPC)
Entity Type:Individual
Prefix:
First Name:NEBOJSA
Middle Name:V
Last Name:ZIMONJIC
Suffix:
Gender:M
Credentials:MS, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MEMORIAL AVE
Mailing Address - Street 2:SUITE M-304
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3732
Mailing Address - Country:US
Mailing Address - Phone:240-580-1919
Mailing Address - Fax:443-276-6712
Practice Address - Street 1:500 MEMORIAL AVE
Practice Address - Street 2:SUITE M-304
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3732
Practice Address - Country:US
Practice Address - Phone:240-580-1919
Practice Address - Fax:443-276-6712
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP4255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional