Provider Demographics
NPI:1518581552
Name:KINSLEY, ZACHARY (LICSW)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:KINSLEY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-2122
Mailing Address - Country:US
Mailing Address - Phone:478-951-5489
Mailing Address - Fax:
Practice Address - Street 1:140 HIGH ST STE 230
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1435
Practice Address - Country:US
Practice Address - Phone:478-951-5489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1254591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical