Healthcare Provider Details

I. General information

NPI: 1275213035
Provider Name (Legal Business Name): NEELMA ZAFAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 SHANTEL DR
SAVOY IL
61874-7812
US

IV. Provider business mailing address

1405 SHANTEL DR
SAVOY IL
61874-7812
US

V. Phone/Fax

Practice location:
  • Phone: 740-418-3864
  • Fax:
Mailing address:
  • Phone: 740-418-3864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149025722
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: