Provider Demographics
NPI:1811101769
Name:ZIESAT, HAROLD ANTHONY (PHD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:ANTHONY
Last Name:ZIESAT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8640 GUILFORD RD STE 252
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2666
Mailing Address - Country:US
Mailing Address - Phone:410-997-1183
Mailing Address - Fax:410-997-1183
Practice Address - Street 1:8640 GUILFORD RD STE 252
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046
Practice Address - Country:US
Practice Address - Phone:410-997-1183
Practice Address - Fax:410-997-1183
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02101103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG316OtherCARE FIRST BLUE SHIELD
MD012818OtherVALUE OPTIONS
DC7845OtherCARE FIRST BLUE SHIELD
MD2161814OtherUNITED BEHAVIORAL HEALTH
MDG316Medicare ID - Type Unspecified