Healthcare Provider Details

I. General information

NPI: 1801205778
Provider Name (Legal Business Name): ARIANA ZENO LSW, MSW, MCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 S 12TH ST
PHILADELPHIA PA
19107-3614
US

IV. Provider business mailing address

4934 WALTON AVE
PHILADELPHIA PA
19143-2009
US

V. Phone/Fax

Practice location:
  • Phone: 215-563-0652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW131769
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: