Provider Demographics
NPI:1114396256
Name:ZUCKERMAN, CORTNEY (LCSW)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:ZUCKERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1684
Mailing Address - Country:US
Mailing Address - Phone:570-510-3890
Mailing Address - Fax:570-961-3364
Practice Address - Street 1:301 W GROVE ST
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2090
Practice Address - Country:US
Practice Address - Phone:570-961-3361
Practice Address - Fax:570-961-3364
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0198461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical