Provider Demographics
NPI:1700841863
Name:ZEMANSKY, MARY F (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:ZEMANSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CAMINO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5456
Mailing Address - Country:US
Mailing Address - Phone:219-805-8612
Mailing Address - Fax:
Practice Address - Street 1:50 CAMINO DEL SOL
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5456
Practice Address - Country:US
Practice Address - Phone:219-805-8612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041368A103T00000X, 103TC0700X
IL071004981103T00000X
AZPSY-001728103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200197170BMedicaid
IN233900AMedicare PIN
IN200197170BMedicaid