Provider Demographics
NPI:1740014695
Name:ZINK, MARY (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ZINK
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:MJ
Other - Middle Name:
Other - Last Name:ZINK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:57 RIGHTMIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-4235
Mailing Address - Country:US
Mailing Address - Phone:304-257-0543
Mailing Address - Fax:
Practice Address - Street 1:57 RIGHTMIRE AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-4235
Practice Address - Country:US
Practice Address - Phone:304-257-0543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009451281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical