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General NPI Number Information
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NPI Number | 1013253715
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Entity Type | Individual
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Provider Name | MICHAEL ZITO II M.A., LPC
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Gender | Male
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Dates
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Enumeration Date | 12/27/2012
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 1090 NORTH STREET SUITE 110
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City | KALAMAZOO
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State | MI
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Zip | 49009
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Country | US
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Telephone | 269-375-4363
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Fax | 269-375-4362
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Provider Business Mailing Address
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Address Line | 10150 PORTAGE RD
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City | PORTAGE
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State | MI
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Zip | 49002-7281
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Country | US
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Telephone | 269-532-2223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401013329
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License Number State | MI
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