Provider Demographics
NPI:1679723639
Name:ZIEKY, JESSICA TYE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:TYE
Last Name:ZIEKY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 HOWARD STREET
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-872-0700
Mailing Address - Fax:508-872-0773
Practice Address - Street 1:214 HOWARD STREET
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-872-0700
Practice Address - Fax:508-872-0773
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1165231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical