MEDICARE: ANTOINETTE ZVORAK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2007030812	MO

General Provider Information

NPI Number	:	1013379148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINETTE ZVORAK LCSW

Provider Business Mailing Address
First Line	:	745 CRAIG RD STE 305
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-7122
Country	:	US
Telephone Number	:	636-566-0101
Fax Number	:	406-296-7951

Provider Business Practice Location Address
First Line	:	745 CRAIG RD STE 305
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7122
Country	:	US
Telephone Number	:	636-566-0101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	03/05/2025

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