Provider Demographics
NPI: | 1306049846 |
---|---|
Name: | KEN ZEIGLER, LLC |
Entity type: | Organization |
Organization Name: | KEN ZEIGLER, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OPERATIONS MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CATHY |
Authorized Official - Middle Name: | LUIGINA |
Authorized Official - Last Name: | KING |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 410-321-6035 |
Mailing Address - Street 1: | 8600 LASALLE RD |
Mailing Address - Street 2: | THE CHESTER BUILDING SUITE 325 |
Mailing Address - City: | TOWSON |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21286-2001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-321-6035 |
Mailing Address - Fax: | 410-321-6176 |
Practice Address - Street 1: | 8600 LASALLE RD |
Practice Address - Street 2: | THE CHESTER BUILDING SUITE 325 |
Practice Address - City: | TOWSON |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21286-2001 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-321-6035 |
Practice Address - Fax: | 410-321-6176 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-06-11 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Single Specialty |