Provider Demographics
NPI:1245677186
Name:ZUIDEMA, JEANNIE L (MM, MSW, ACSW, LCSW)
Entity type:Individual
Prefix:
First Name:JEANNIE
Middle Name:L
Last Name:ZUIDEMA
Suffix:
Gender:F
Credentials:MM, MSW, ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4342
Mailing Address - Country:US
Mailing Address - Phone:406-860-5215
Mailing Address - Fax:
Practice Address - Street 1:2520 5TH AVE S
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4342
Practice Address - Country:US
Practice Address - Phone:406-860-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2013-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCSW-LIC44661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical