Healthcare Provider Details

I. General information

NPI: 1962957787
Provider Name (Legal Business Name): MEGAN MICHELE ZELINSKY LMSW, MPA, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 GRANDVILLE AVE SW
GRAND RAPIDS MI
49503-4920
US

IV. Provider business mailing address

629 LYON ST NE # 2
GRAND RAPIDS MI
49503-3445
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-8424
  • Fax: 616-685-8403
Mailing address:
  • Phone: 248-760-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801096593
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: