Provider Demographics
NPI:1841413259
Name:ZUCKERBROD, JO ANN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:
Last Name:ZUCKERBROD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:JO ANN
Other - Middle Name:
Other - Last Name:ZUCKERBROD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:237 STRAWBERRY HILL AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2567
Mailing Address - Country:US
Mailing Address - Phone:203-353-8405
Mailing Address - Fax:203-327-7508
Practice Address - Street 1:237 STRAWBERRY HILL AVE APT 33
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2567
Practice Address - Country:US
Practice Address - Phone:203-353-8405
Practice Address - Fax:203-327-7508
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0026591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical