Healthcare Provider Details

I. General information

NPI: 1194755603
Provider Name (Legal Business Name): TIM ZIELINSKI LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 NORTHLAND DR STE A
GRAND RAPIDS MI
49525
US

IV. Provider business mailing address

5250 NORTHLAND DR STE A
GRAND RAPIDS MI
49525
US

V. Phone/Fax

Practice location:
  • Phone: 616-361-5001
  • Fax: 616-361-2166
Mailing address:
  • Phone: 616-361-5001
  • Fax: 616-361-2166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: