Provider Demographics
NPI:1073047122
Name:ZASZCZURYNSKI, THERESA (LMSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:ZASZCZURYNSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6801 DALE CT
Mailing Address - Street 2:
Mailing Address - City:FENNVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49408-8601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6801 DALE CT
Practice Address - Street 2:
Practice Address - City:FENNVILLE
Practice Address - State:MI
Practice Address - Zip Code:49408-8601
Practice Address - Country:US
Practice Address - Phone:616-886-0757
Practice Address - Fax:269-743-4100
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-15
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801097329104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker