Provider Demographics
NPI:1275711921
Name:ZANONE, CHARLES F IV (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:ZANONE
Suffix:IV
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 JENNINGS MILL RD UNIT 2000B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7252
Mailing Address - Country:US
Mailing Address - Phone:706-201-6921
Mailing Address - Fax:888-858-1679
Practice Address - Street 1:1551 JENNINGS MILL RD UNIT 2000B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7252
Practice Address - Country:US
Practice Address - Phone:706-201-6921
Practice Address - Fax:888-858-1679
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002281103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling