Healthcare Provider Details

I. General information

NPI: 1932017738
Provider Name (Legal Business Name): ZACHARY SCOTT MARKO MPS, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 S 6TH ST
MINNEAPOLIS MN
55454-1336
US

IV. Provider business mailing address

1966 ORANGE AVE E
SAINT PAUL MN
55119-3261
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-2876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306081
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: