MEDICARE: ALEX ZOLOTO LPC

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	101YM0800X	Mental Health Counselor	LAC-15982	AZ
2	101YM0800X	Mental Health Counselor	LPC-18393	AZ

General Provider Information

NPI Number	:	1497304968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX ZOLOTO LPC

Provider Business Mailing Address
First Line	:	14602 E LARKSPUR DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85259-2105
Country	:	US
Telephone Number	:	480-200-1443
Fax Number	:

Provider Business Practice Location Address
First Line	:	14602 E LARKSPUR DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85259-2105
Country	:	US
Telephone Number	:	480-382-6038
Fax Number	:

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

Provider Enumeration Date	:	09/08/2019
Last Update Date	:	09/23/2019

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