Healthcare Provider Details

I. General information

NPI: 1689244113
Provider Name (Legal Business Name): MATTHEW KENT ZINKIL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 07/13/2024
Certification Date: 07/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 FIRST STREET
DOVER DE
19902
US

IV. Provider business mailing address

60 BELFRY DR
FELTON DE
19943-7400
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-2000
  • Fax:
Mailing address:
  • Phone: 302-566-5855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30566
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC015963
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: