Healthcare Provider Details

I. General information

NPI: 1073495925
Provider Name (Legal Business Name): STEPHEN MICHAEL ZUSHIN CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 HENNETTA AVE
AKRON OH
44320-1026
US

IV. Provider business mailing address

2542 HENNETTA AVE
AKRON OH
44320-1026
US

V. Phone/Fax

Practice location:
  • Phone: 828-493-7351
  • Fax:
Mailing address:
  • Phone: 828-493-7351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.193164
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: