Provider Demographics
NPI:1629257662
Name:ZECK, JULIE A (LCMFT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:ZECK
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 BROADWAY AVE
Mailing Address - Street 2:THE CENTER FOR COUNSELING AND CONSULTATION
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-3123
Mailing Address - Country:US
Mailing Address - Phone:620-792-2544
Mailing Address - Fax:620-792-7052
Practice Address - Street 1:5815 BROADWAY
Practice Address - Street 2:THE CENTER FOR COUNSELING
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530
Practice Address - Country:US
Practice Address - Phone:620-792-2544
Practice Address - Fax:620-792-4323
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100387640BMedicaid