Provider Demographics
NPI:1144836818
Name:BERMAN, ZACHARY LANE (LGMFT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:LANE
Last Name:BERMAN
Suffix:
Gender:M
Credentials:LGMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11806 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2057
Mailing Address - Country:US
Mailing Address - Phone:240-731-6832
Mailing Address - Fax:
Practice Address - Street 1:4905 DEL RAY AVE STE 403
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2557
Practice Address - Country:US
Practice Address - Phone:240-686-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist