Provider Demographics
NPI:1811593031
Name:ZENSKY-ORTT, NICOLE R (MA, LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:R
Last Name:ZENSKY-ORTT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:R
Other - Last Name:ZENSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-1350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-1350
Practice Address - Country:US
Practice Address - Phone:610-944-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012737101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor