Provider Demographics
NPI:1871357731
Name:BRANT, ZALENE (LPC-R, ATR, CSAC-S)
Entity type:Individual
Prefix:
First Name:ZALENE
Middle Name:
Last Name:BRANT
Suffix:
Gender:F
Credentials:LPC-R, ATR, CSAC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 BLUE JAY CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1283
Mailing Address - Country:US
Mailing Address - Phone:704-530-2581
Mailing Address - Fax:
Practice Address - Street 1:6655 SANTA BARBARA RD UNIT 8574
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-7523
Practice Address - Country:US
Practice Address - Phone:866-968-6342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0709024611101YA0400X
VA21-495221700000X
VA0704014166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist