Provider Demographics
NPI:1457995805
Name:GENKIN, ZOE BRETT (LMSW)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:BRETT
Last Name:GENKIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10309 THORNBUSH LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2155
Mailing Address - Country:US
Mailing Address - Phone:301-919-4224
Mailing Address - Fax:
Practice Address - Street 1:1009 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5055
Practice Address - Country:US
Practice Address - Phone:443-478-3619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25515104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker