1942511340 NPI number — TERRENCE FRANCIS ZIELINSKI MSW, LICSW

Table of content: TERRENCE FRANCIS ZIELINSKI MSW, LICSW (NPI 1942511340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942511340 NPI number — TERRENCE FRANCIS ZIELINSKI MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIELINSKI
Provider First Name:
TERRENCE
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW
Provider Gender Code:
M

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:
1942511340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 MALL DR.
Provider Second Line Business Mailing Address:
HEARTLAND PCA, LLC, DBA HEARTLAND KIDS
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-727-0990
Provider Business Mailing Address Fax Number:
218-491-7050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
324 W. SUPERIOR ST.
Provider Second Line Business Practice Location Address:
STE. 509 HEARTLAND PCA, LLC, DBA HEARTLAND KIDS
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-727-4411
Provider Business Practice Location Address Fax Number:
218-727-4466
Provider Enumeration Date:
06/30/2010

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: 1041C0700X , with the licence number:  5347 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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