Provider Demographics
NPI:1790792620
Name:ZACCHETTI, DENNIS JOHN (PSYD, LADC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JOHN
Last Name:ZACCHETTI
Suffix:
Gender:M
Credentials:PSYD, LADC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 9 BOX 2232
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-0023
Mailing Address - Country:US
Mailing Address - Phone:496-562-1300
Mailing Address - Fax:
Practice Address - Street 1:WILHELM-WASCHBISCH STR 8
Practice Address - Street 2:
Practice Address - City:BEILINGEN
Practice Address - State:RHEINLAN PFALZ
Practice Address - Zip Code:54662
Practice Address - Country:DE
Practice Address - Phone:496-562-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000049106H00000X
CT000761101YA0400X
PA001967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT#UNAVAILABLEOtherCOSMO
WIMOU #250OtherTRICARE