Provider Demographics
NPI:1093477309
Name:ZEN PSYCHOLOGICAL CENTER
Entity type:Organization
Organization Name:ZEN PSYCHOLOGICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-687-8507
Mailing Address - Street 1:11 BYTE CT STE C
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8718
Mailing Address - Country:US
Mailing Address - Phone:301-246-0206
Mailing Address - Fax:
Practice Address - Street 1:11 BYTE CT STE C
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-8718
Practice Address - Country:US
Practice Address - Phone:240-457-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty