Provider Demographics
NPI:1295811644
Name:ZIEGLER, MARY LYNNE (LCSW-C)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:LYNNE
Last Name:ZIEGLER
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:PO BOX 973
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-0973
Mailing Address - Country:US
Mailing Address - Phone:410-848-5785
Mailing Address - Fax:410-848-5629
Practice Address - Street 1:30 N COURT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5110
Practice Address - Country:US
Practice Address - Phone:443-821-8989
Practice Address - Fax:866-664-2949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0169951041C0700X
MD047661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0455911Medicaid