Provider Demographics
NPI:1649075110
Name:TALEBI, ZAKAREAH (LPC)
Entity type:Individual
Prefix:
First Name:ZAKAREAH
Middle Name:
Last Name:TALEBI
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 N PROSPECT AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1947
Mailing Address - Country:US
Mailing Address - Phone:414-334-1011
Mailing Address - Fax:
Practice Address - Street 1:1732 N PROSPECT AVE APT 105
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1947
Practice Address - Country:US
Practice Address - Phone:414-334-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8576-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty