Healthcare Provider Details

I. General information

NPI: 1437728615
Provider Name (Legal Business Name): CASEY ZINSER LMHC, NCC, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MASONIC AVE
HOLTSVILLE NY
11742-2399
US

IV. Provider business mailing address

100 S MAIN ST STE 204
SAYVILLE NY
11782-3148
US

V. Phone/Fax

Practice location:
  • Phone: 631-338-1814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: