Provider Demographics
NPI:1508603572
Name:ZUMWALT, FRED HUNT (LPC)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:HUNT
Last Name:ZUMWALT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ASH LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1272
Mailing Address - Country:US
Mailing Address - Phone:703-898-5827
Mailing Address - Fax:
Practice Address - Street 1:2052 RICHMOND HWY STE 201
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7286
Practice Address - Country:US
Practice Address - Phone:703-898-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional