Provider Demographics
NPI:1598596660
Name:ZILUCA, CHRISTINE (LCSW-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ZILUCA
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 1:5104 ILCHESTER WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6306
Mailing Address - Country:US
Mailing Address - Phone:410-258-3449
Mailing Address - Fax:
Practice Address - Street 1:5104 ILCHESTER WOODS WAY
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6306
Practice Address - Country:US
Practice Address - Phone:410-258-3449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD086681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical