Provider Demographics
NPI:1265806814
Name:MARY HUSS ZETELSKI, LCSW, LLC
Entity type:Organization
Organization Name:MARY HUSS ZETELSKI, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HUSS
Authorized Official - Last Name:ZETELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-933-0987
Mailing Address - Street 1:101 CEDAR LN STE 303
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4417
Mailing Address - Country:US
Mailing Address - Phone:201-933-0987
Mailing Address - Fax:
Practice Address - Street 1:101 CEDAR LN STE 303
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4417
Practice Address - Country:US
Practice Address - Phone:201-933-0987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052457001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty