Provider Demographics
NPI:1023680808
Name:ZINN, MICHELLE CHERICE (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CHERICE
Last Name:ZINN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 SOMBRERO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86404-3239
Mailing Address - Country:US
Mailing Address - Phone:928-230-7276
Mailing Address - Fax:
Practice Address - Street 1:3131 SOMBRERO DR
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86404-3239
Practice Address - Country:US
Practice Address - Phone:928-230-7276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-6993104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker