Healthcare Provider Details

I. General information

NPI: 1841590874
Provider Name (Legal Business Name): LINDSEY E ZASKIEWICZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 TREMONT BLVD NW
GRAND RAPIDS MI
49504-4868
US

IV. Provider business mailing address

550 CHERRY ST SE
GRAND RAPIDS MI
49503-4748
US

V. Phone/Fax

Practice location:
  • Phone: 616-791-6593
  • Fax:
Mailing address:
  • Phone: 616-776-2113
  • Fax: 616-235-7506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092527
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: