MEDICARE: BARBARA JEAN ZOOG LICDC,SAP,CTT,LSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	923378	OH

General Provider Information

NPI Number	:	1265739528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JEAN ZOOG LICDC,SAP,CTT,LSW

Provider Business Mailing Address
First Line	:	8684 EASTON DR
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-9607
Country	:	US
Telephone Number	:	614-205-9714
Fax Number	:	614-920-1807

Provider Business Practice Location Address
First Line	:	8563 REFUGEE RD
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-9639
Country	:	US
Telephone Number	:	614-837-8000
Fax Number	:

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

Provider Enumeration Date	:	02/23/2011
Last Update Date	:	02/23/2011

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