Provider Demographics
NPI:1790377893
Name:GUERRERO BALLESTEROS, ZULEMA C (LCSW)
Entity type:Individual
Prefix:
First Name:ZULEMA
Middle Name:C
Last Name:GUERRERO BALLESTEROS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ZULEMA
Other - Middle Name:
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:134 N 4TH ST OFC 2010
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3296
Mailing Address - Country:US
Mailing Address - Phone:646-450-7748
Mailing Address - Fax:
Practice Address - Street 1:4600 E WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-1908
Practice Address - Country:US
Practice Address - Phone:646-450-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-19083104100000X
NY0993131041C0700X
WALW615768761041C0700X
VT089.01359001041C0700X
AZLCSW-217801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker