Provider Demographics
NPI:1720564107
Name:ZULAKIS, ZOE (MSW)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:ZULAKIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 N 21ST ST # 195
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2956
Mailing Address - Country:US
Mailing Address - Phone:614-610-1396
Mailing Address - Fax:
Practice Address - Street 1:1067 N 21ST ST # 195
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2956
Practice Address - Country:US
Practice Address - Phone:614-610-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2022-03-07
Deactivation Date:2019-08-14
Deactivation Code:
Reactivation Date:2022-02-17
Provider Licenses
StateLicense IDTaxonomies
MN271871041C0700X
MI68010969951041C0700X
OHI.21027701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical