Healthcare Provider Details

I. General information

NPI: 1073322814
Provider Name (Legal Business Name): RACHEL ZIKO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY DEPT OF
JEFFERSON LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HWY DEPT OF
JEFFERSON LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-703-2390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14103
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: