Provider Demographics
NPI:1215337407
Name:ZEGARELLI, TERESA (LGSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ZEGARELLI
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 I ST NE
Mailing Address - Street 2:APT 309
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4489
Mailing Address - Country:US
Mailing Address - Phone:202-520-7998
Mailing Address - Fax:
Practice Address - Street 1:1375 MOUNT OLIVET RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2509
Practice Address - Country:US
Practice Address - Phone:202-520-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500808391041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool