Provider Demographics
NPI:1497847743
Name:ZEBROWSKI, EDWARD ZBIGNIEW (MSW, LCSW, BCD)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ZBIGNIEW
Last Name:ZEBROWSKI
Suffix:
Gender:M
Credentials:MSW, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 MAIN ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7407
Mailing Address - Country:US
Mailing Address - Phone:303-776-7680
Mailing Address - Fax:303-776-7693
Practice Address - Street 1:1707 MAIN ST
Practice Address - Street 2:SUITE 404
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7407
Practice Address - Country:US
Practice Address - Phone:303-776-7680
Practice Address - Fax:303-776-7693
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9840421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07984040Medicaid
CO07984040Medicaid
CO61606Medicare ID - Type Unspecified