Healthcare Provider Details

I. General information

NPI: 1356500359
Provider Name (Legal Business Name): MARLO CARNEY ZARZAUR ED.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 JUNCTION RD STE 6500
MADISON WI
53717-2153
US

IV. Provider business mailing address

2409 PARMENTER ST APT 425
MIDDLETON WI
53562-2687
US

V. Phone/Fax

Practice location:
  • Phone: 608-205-8651
  • Fax: 608-470-7481
Mailing address:
  • Phone: 901-734-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2208
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4394
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC2208
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateTN
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10746-125
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC2008
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: