Provider Demographics
NPI:1891000618
Name:ZANG, VICKY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:ZANG
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12676 NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21536-3320
Mailing Address - Country:US
Mailing Address - Phone:301-895-8087
Mailing Address - Fax:301-895-8097
Practice Address - Street 1:12676 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21536-3320
Practice Address - Country:US
Practice Address - Phone:301-895-8087
Practice Address - Fax:301-895-8097
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD161491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD035380900Medicaid