Provider Demographics
NPI:1326441494
Name:ZUCCARO, LAUREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:ZUCCARO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5533
Mailing Address - Country:US
Mailing Address - Phone:614-487-8758
Mailing Address - Fax:
Practice Address - Street 1:431 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5533
Practice Address - Country:US
Practice Address - Phone:614-487-8758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3151595103TS0200X
OHSP00675103TS0200X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No251S00000XAgenciesCommunity/Behavioral Health