Provider Demographics
NPI:1184686198
Name:ZINNER, ROSLYN (LCSW C MSW)
Entity type:Individual
Prefix:
First Name:ROSLYN
Middle Name:
Last Name:ZINNER
Suffix:
Gender:F
Credentials:LCSW C MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8288 TELEGRAPH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1130
Mailing Address - Country:US
Mailing Address - Phone:410-672-2237
Mailing Address - Fax:410-695-6038
Practice Address - Street 1:8288 TELEGRAPH RD
Practice Address - Street 2:SUITE A
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1130
Practice Address - Country:US
Practice Address - Phone:410-672-2237
Practice Address - Fax:410-695-6038
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD026791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
128207OtherVALUE OPTIONS AND GREAT W
4347247OtherAETNA BEHAVIORAL HEALTH
47474OtherMAMSI UNITED HEALTH CARE
513270OtherNCPPO INNOVA MHIP
52253405OtherBLUE SHIELD OF MD
0006OtherBLUE SHIELD FEDERAL
162197OtherMHN AND TRICARE
10764419OtherCAQH
S003OtherBLUE SHIELD FEDERAL GROUP
162197OtherMHN AND TRICARE
4347247OtherAETNA BEHAVIORAL HEALTH
S003OtherBLUE SHIELD FEDERAL GROUP