Provider Demographics
NPI:1033692637
Name:ZIPPER, JARED ROSS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:ROSS
Last Name:ZIPPER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5030 CHAMPION BLVD STE G11-535
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2473
Mailing Address - Country:US
Mailing Address - Phone:561-464-5500
Mailing Address - Fax:561-464-5501
Practice Address - Street 1:6405 CONGRESS AVE STE 160
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2861
Practice Address - Country:US
Practice Address - Phone:561-464-5500
Practice Address - Fax:561-464-5501
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW176682083A0300X
FL1041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No104100000XBehavioral Health & Social Service ProvidersSocial Worker