Provider Demographics
NPI:1063781011
Name:WINDING ROAD COUNSELING, LLC
Entity type:Organization
Organization Name:WINDING ROAD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR AND PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ZWARICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-618-8947
Mailing Address - Street 1:8370 COURT AVE STE 201
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4689
Mailing Address - Country:US
Mailing Address - Phone:443-618-8947
Mailing Address - Fax:443-769-1195
Practice Address - Street 1:8370 COURT AVE STE 201
Practice Address - Street 2:SUITE 201
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4689
Practice Address - Country:US
Practice Address - Phone:443-618-8947
Practice Address - Fax:443-769-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124357470OtherINDIVIDUAL NPI