Provider Demographics
NPI:1255366993
Name:ZENNER, TERRY JOSEPH (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:JOSEPH
Last Name:ZENNER
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 KALISTE SALOOM RD STE C8
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6140
Mailing Address - Country:US
Mailing Address - Phone:337-989-9350
Mailing Address - Fax:
Practice Address - Street 1:1720 KALISTE SALOOM RD STE C8
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6140
Practice Address - Country:US
Practice Address - Phone:337-989-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical