Provider Demographics
NPI:1275527590
Name:ZACCARI, ANNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:ZACCARI
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 1:1717 N 77TH ST STE 19
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-2261
Mailing Address - Country:US
Mailing Address - Phone:480-421-1431
Mailing Address - Fax:480-421-1436
Practice Address - Street 1:1717 N 77TH ST
Practice Address - Street 2:SUITE 14
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-2238
Practice Address - Country:US
Practice Address - Phone:480-421-1431
Practice Address - Fax:480-421-1436
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-41151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ145710Medicare PIN