Provider Demographics
NPI:1275800138
Name:ZUK, GREGORY ALAN (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALAN
Last Name:ZUK
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 JACOB ST
Mailing Address - Street 2:STE 501
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3800
Mailing Address - Country:US
Mailing Address - Phone:304-234-8517
Mailing Address - Fax:304-234-8745
Practice Address - Street 1:107 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8786
Practice Address - Country:US
Practice Address - Phone:740-526-0204
Practice Address - Fax:740-526-0207
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0900171101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor