Healthcare Provider Details

I. General information

NPI: 1750119442
Provider Name (Legal Business Name): ZIONE PSYCHIATRY AND COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 DEPOT LN SE
CEDAR RAPIDS IA
52401-2550
US

IV. Provider business mailing address

6070 WOODBRIDGE CRST
MARION IA
52302-9551
US

V. Phone/Fax

Practice location:
  • Phone: 815-570-9701
  • Fax:
Mailing address:
  • Phone: 815-570-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1992390371
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerAPRN
# 2
Identifier1730514415
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerAPRN

VIII. Authorized Official

Name: ANNA SHUDZEKA
Title or Position: PSYCHIATRY NP
Credential: APRN
Phone: 815-570-9701