Healthcare Provider Details

I. General information

NPI: 1639668684
Provider Name (Legal Business Name): MRS. MEREDITH L ZORNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2018
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E STATE ST STE D
ATHENS OH
45701-1870
US

IV. Provider business mailing address

400 E STATE ST STE D
ATHENS OH
45701-1870
US

V. Phone/Fax

Practice location:
  • Phone: 740-326-6110
  • Fax:
Mailing address:
  • Phone: 740-326-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2102996
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2102996-TRNE
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC2406414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: