Provider Demographics
NPI:1265739528
Name:ZOOG, BARBARA JEAN (LICDC,SAP,CTT,LSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:ZOOG
Suffix:
Gender:F
Credentials:LICDC,SAP,CTT,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8684 EASTON DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9607
Mailing Address - Country:US
Mailing Address - Phone:614-205-9714
Mailing Address - Fax:614-920-1807
Practice Address - Street 1:8563 REFUGEE RD
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9639
Practice Address - Country:US
Practice Address - Phone:614-837-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH923378101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)