Provider Demographics
NPI:1801980362
Name:ZELIGMAN, REBECCA A (LCSW-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:ZELIGMAN
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 1:6163 DEVON DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:443-801-7146
Mailing Address - Fax:410-992-4574
Practice Address - Street 1:5022 DORSEY HALL DR
Practice Address - Street 2:101
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7711
Practice Address - Country:US
Practice Address - Phone:443-801-7146
Practice Address - Fax:410-730-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03612104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD725786OtherNCPPO
MD238252OtherMAMSI ID
MD41850101OtherCAREFIRST MD PLAN
MD36140004OtherCAREFIRST DC PLAN