Provider Demographics
NPI:1093084626
Name:ZELENSKI, JOHN LANDON (MA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LANDON
Last Name:ZELENSKI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 JEFFREYS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3922
Mailing Address - Country:US
Mailing Address - Phone:702-939-9431
Mailing Address - Fax:
Practice Address - Street 1:10301 JEFFREYS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3922
Practice Address - Country:US
Practice Address - Phone:702-939-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty