Healthcare Provider Details

I. General information

NPI: 1437604436
Provider Name (Legal Business Name): ZOE LAZAR-HALE L.P.C., C.A.A.D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 W BURNSIDE ST
CARO MI
48723-1507
US

IV. Provider business mailing address

412 GREENFIELD AVE
FLINT MI
48503-2165
US

V. Phone/Fax

Practice location:
  • Phone: 810-294-0814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6401015530
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401017953
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: