MEDICARE: ZEN LIFE MENTAL WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1548006091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEN LIFE MENTAL WELLNESS, LLC

Provider Business Mailing Address
First Line	:	2464 FLEETWOOD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-8321
Country	:	US
Telephone Number	:	513-545-9665
Fax Number	:

Provider Business Practice Location Address
First Line	:	7364 READING RD STE B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3451
Country	:	US
Telephone Number	:	513-545-9665
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OLIVIA SZERSZEN
Credential	:	PMHNP
Telephone Number	:	513-545-9665

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	11/04/2024

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