Zakutansky, Theresa Joan

Zakutansky, Theresa Joan is an individual health care provider with primary practice located at 910 Elm Grove Rd Ste 11B , Elm Grove WI 53122-2531. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Zakutansky, Theresa Joan can be contacted via phone (262) 780-1001.

Contact Information

Primary practice address
910 Elm Grove Rd Ste 11B Elm Grove WI 53122-2531
Phone: (262) 780-1001
Fax: (262) 780-1002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1941-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 383-124 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1828-132 Wisconsin

Profile Details

NPI number 1205993482
LBN Legal business name Zakutansky, Theresa Joan
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated May 9th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205993482 NPPES
Wisconsin MEDICAID 1205993482

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