Provider Demographics
NPI:1053847905
Name:ZIARKO, JOSEPH J (LICDC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:ZIARKO
Suffix:
Gender:M
Credentials:LICDC
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:J
Other - Last Name:ZIARKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICDC943952
Mailing Address - Street 1:6499 STATE ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:OH
Mailing Address - Zip Code:44234-9712
Mailing Address - Country:US
Mailing Address - Phone:330-842-7354
Mailing Address - Fax:
Practice Address - Street 1:143 GOUGLER AVE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2401
Practice Address - Country:US
Practice Address - Phone:330-677-4124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC943952101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)