Provider Demographics
NPI:1063024537
Name:ZARATE, JOHNATHON ELIZAIO (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHNATHON
Middle Name:ELIZAIO
Last Name:ZARATE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:ELIZAIO
Other - Last Name:ZARATE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:275 CHATEAU LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-1405
Mailing Address - Country:US
Mailing Address - Phone:409-466-5325
Mailing Address - Fax:
Practice Address - Street 1:275 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-1405
Practice Address - Country:US
Practice Address - Phone:409-466-5325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical