Healthcare Provider Details

I. General information

NPI: 1023179025
Provider Name (Legal Business Name): JOHN ZIELIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N CANAL ST FAMILY SERVICE, INC.
LAWRENCE MA
01840-1246
US

IV. Provider business mailing address

2 PIONEER CIR
ANDOVER MA
01810-3413
US

V. Phone/Fax

Practice location:
  • Phone: 978-683-9505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103186-1
License Number StateMA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: