Provider Demographics
NPI:1851011688
Name:ZADIKOFF, ISAAC-IKE (LMHC)
Entity Type:Individual
Prefix:
First Name:ISAAC-IKE
Middle Name:
Last Name:ZADIKOFF
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12270 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2421
Mailing Address - Country:US
Mailing Address - Phone:786-374-7874
Mailing Address - Fax:
Practice Address - Street 1:19415 LENAIRE DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8544
Practice Address - Country:US
Practice Address - Phone:786-374-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health