Provider Demographics
NPI:1780026237
Name:BURNS, ZACHARY EDWARD (MA)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:EDWARD
Last Name:BURNS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 150 S
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-9606
Mailing Address - Country:US
Mailing Address - Phone:219-916-2521
Mailing Address - Fax:
Practice Address - Street 1:30 E 150 S
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-9606
Practice Address - Country:US
Practice Address - Phone:219-916-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99058271A104100000X
IN34007410A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker