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General NPI Number Information
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NPI Number | 1255612503
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Entity Type | Individual
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Provider Name | STEVEN ZESSIS LICSW
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Gender | Male
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 126 PHOENIX AVE 3RD FLOOR
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City | LOWELL
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State | MA
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Zip | 01852-4931
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Country | US
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Telephone | 978-513-2393
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SHERWOOD RD
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City | READING
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State | MA
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Zip | 01867-3744
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Country | US
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Telephone | 781-944-1375
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111800
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License Number State | MA
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