Provider Demographics
NPI:1801503081
Name:CHUCK ZANONE, PH.D., LLC
Entity type:Organization
Organization Name:CHUCK ZANONE, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:ZANONE
Authorized Official - Suffix:IV
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-201-6921
Mailing Address - Street 1:1551 JENNINGS MILL RD UNIT 2000B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7252
Mailing Address - Country:US
Mailing Address - Phone:706-201-6921
Mailing Address - Fax:888-858-1679
Practice Address - Street 1:1551 JENNINGS MILL RD UNIT 2000B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7252
Practice Address - Country:US
Practice Address - Phone:706-201-6921
Practice Address - Fax:888-858-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty