Provider Demographics
NPI:1780856831
Name:ZELESKY, BRIAN ANDREW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ANDREW
Last Name:ZELESKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LINDSEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5357
Mailing Address - Country:US
Mailing Address - Phone:860-538-3302
Mailing Address - Fax:
Practice Address - Street 1:25 CONCORD ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2135
Practice Address - Country:US
Practice Address - Phone:860-538-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0064341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical