Kellie Zundel, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904012755 Issued in VA

Practice address

932 Hungerford Dr Ste 35B
Rockville, MD 20850-1753

Phone

(571) 336-6841

NPI assigned

Mar 30, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 8, 2022 through Nov 8, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1164000428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S EADS ST APT 215",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222023030",
            "telephone_number": "801-425-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 HUNGERFORD DR STE 35B",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501753",
            "telephone_number": "571-336-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUNDEL",
        "first_name": "KELLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Zucker, PSY.D.
• David Jay Zuckerman, M.D.
• Lester Alan Zuckerman, M.D.
• Jennifer Haya Zuhl, MA
• Jas Zuluaga
• Francis E Zuniga, PT, DPT
• Oney J Zuniga, MD
• Vicky Natalie Zuniga, LCSW-C, LICSW
• Inna Zusman, LGPC
• Laura Lyn Zynda, LMSW

• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.