Healthcare Provider Details

I. General information

NPI: 1477943249
Provider Name (Legal Business Name): HOWARD ZUCKERMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38807 ANN ARBOR RD STE 9
LIVONIA MI
48150-3896
US

IV. Provider business mailing address

38807 ANN ARBOR RD STE 9
LIVONIA MI
48150-3896
US

V. Phone/Fax

Practice location:
  • Phone: 734-772-0148
  • Fax: 734-943-6051
Mailing address:
  • Phone: 734-772-0148
  • Fax: 734-943-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6401014526
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401014526
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: