Provider Demographics
NPI:1265720049
Name:ZENK, JEAN L (MS, LPCC, LADC, NCC)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:L
Last Name:ZENK
Suffix:
Gender:F
Credentials:MS, LPCC, LADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CIVIC CENTER PLZ
Mailing Address - Street 2:SUITE 2090
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-7781
Mailing Address - Country:US
Mailing Address - Phone:507-345-4679
Mailing Address - Fax:507-345-8685
Practice Address - Street 1:12 CIVIC CENTER PLZ
Practice Address - Street 2:SUITE 2090
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7781
Practice Address - Country:US
Practice Address - Phone:507-345-4679
Practice Address - Fax:507-345-8685
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00325101YM0800X
MN300589101YM0800X
MN57441101YM0800X
MN5464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health