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General NPI Number Information
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NPI Number | 1861841728
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Entity Type | Individual
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Provider Name | JONATHAN ZALESNE MA, LPC
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Gender | Male
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 1502 S COLLEGE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-4116
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Country | US
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Telephone | 303-667-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 3143 TWIN WASH SQ
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City | FORT COLLINS
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State | CO
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Zip | 80528-9439
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Country | US
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Telephone | 303-667-2940
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC.0012104
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC.0012104
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0012104
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License Number State | CO
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