Healthcare Provider Details

I. General information

NPI: 1609071166
Provider Name (Legal Business Name): CHRISTINE ZINKE MA, LCSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ASHLEY PL
WESTFORD MA
01886-4537
US

IV. Provider business mailing address

6 ASHLEY PL
WESTFORD MA
01886-4537
US

V. Phone/Fax

Practice location:
  • Phone: 973-476-1444
  • Fax:
Mailing address:
  • Phone: 973-476-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115260
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number084389
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5565
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04560700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: