Provider Demographics
NPI:1013207943
Name:ZENITH PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:ZENITH PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SUSAG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:651-788-0538
Mailing Address - Street 1:2175 HIGHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1314
Mailing Address - Country:US
Mailing Address - Phone:651-698-1670
Mailing Address - Fax:
Practice Address - Street 1:2175 HIGHLAND PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1314
Practice Address - Country:US
Practice Address - Phone:651-698-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC0182251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health