Provider Demographics
NPI:1477037711
Name:ZOOK, LEAH MARIE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:ZOOK
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E SUPERIOR ST STE 415
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2007
Mailing Address - Country:US
Mailing Address - Phone:218-393-5407
Mailing Address - Fax:218-730-2367
Practice Address - Street 1:11 E SUPERIOR ST STE 415
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2007
Practice Address - Country:US
Practice Address - Phone:218-393-5407
Practice Address - Fax:218-730-2367
Is Sole Proprietor?:No
Enumeration Date:2018-09-22
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN226341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical