1629257662 NPI number — MS. JULIE A ZECK LCMFT

Table of content: MS. JULIE A ZECK LCMFT (NPI 1629257662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629257662 NPI number — MS. JULIE A ZECK LCMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZECK
Provider First Name:
JULIE
Provider Middle Name:
A
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629257662
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5815 BROADWAY AVE
Provider Second Line Business Mailing Address:
THE CENTER FOR COUNSELING AND CONSULTATION
Provider Business Mailing Address City Name:
GREAT BEND
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67530-3123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-792-2544
Provider Business Mailing Address Fax Number:
620-792-7052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5815 BROADWAY
Provider Second Line Business Practice Location Address:
THE CENTER FOR COUNSELING
Provider Business Practice Location Address City Name:
GREAT BEND
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-792-2544
Provider Business Practice Location Address Fax Number:
620-792-4323
Provider Enumeration Date:
10/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100387640B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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