Provider Demographics
NPI:1063651818
Name:ZEAK DESHPANDE, JENNIFER LYNN (LISW, LCSW, PIP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:ZEAK DESHPANDE
Suffix:
Gender:F
Credentials:LISW, LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 CHAMPIONS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6471
Mailing Address - Country:US
Mailing Address - Phone:334-887-5244
Mailing Address - Fax:334-826-2111
Practice Address - Street 1:2375 CHAMPIONS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6471
Practice Address - Country:US
Practice Address - Phone:334-887-5244
Practice Address - Fax:334-826-2111
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0922-2250C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical