Healthcare Provider Details

I. General information

NPI: 1275800138
Provider Name (Legal Business Name): GREGORY ALAN ZUK MSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PLAZA DR
SAINT CLAIRSVILLE OH
43950-8786
US

IV. Provider business mailing address

2101 JACOB ST STE 501
WHEELING WV
26003-3800
US

V. Phone/Fax

Practice location:
  • Phone: 740-526-0204
  • Fax: 740-526-0207
Mailing address:
  • Phone: 304-234-8517
  • Fax: 304-234-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberI.0900171
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: