Provider Demographics
NPI:1164986055
Name:ZARANDONA COUNSELING AND ASSESSMENT SERVICES LLC
Entity Type:Organization
Organization Name:ZARANDONA COUNSELING AND ASSESSMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:ZARANDONA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:574-999-4544
Mailing Address - Street 1:61723 OAK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-9648
Mailing Address - Country:US
Mailing Address - Phone:574-206-3937
Mailing Address - Fax:
Practice Address - Street 1:120 S TAYLOR ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1522
Practice Address - Country:US
Practice Address - Phone:574-999-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)