Provider Demographics
NPI:1780058339
Name:ZOCHERT, MICHAEL (LMHC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ZOCHERT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-1408
Mailing Address - Country:US
Mailing Address - Phone:319-365-3993
Mailing Address - Fax:319-364-0116
Practice Address - Street 1:1730 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5433
Practice Address - Country:US
Practice Address - Phone:319-365-3993
Practice Address - Fax:319-364-0116
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080199104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA104339000Medicaid