Provider Demographics
NPI:1013425289
Name:JACOB-ZYSMAN, CLAIRE MARCIA (MA, R-DMT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARCIA
Last Name:JACOB-ZYSMAN
Suffix:
Gender:F
Credentials:MA, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3212
Mailing Address - Country:US
Mailing Address - Phone:585-747-0253
Mailing Address - Fax:
Practice Address - Street 1:877 SOUTH ST STE 200
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8243
Practice Address - Country:US
Practice Address - Phone:413-236-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health