Doctor Name: | MR. KENNETH JAY ZUMBAUGH |
NPI Number: | 1801824842 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LMHC |
License Number: | 39000953A |
Business Practice Address: | 655 E Main St Peru, IN - 469702662 |
Business Phone Number: | 7654721931 |
Business Fax Number: | 7654721945 |
Mailing Address: | 1015 Michigan Ave, LOGANSPORT |
State: | IN |
Postal Code: | 469471526 |
Phone Number: | 5747225151 |
Fax Number: | 5747391414 |
NPI Enumeration Date: | 06/29/2006 |
NPI Last Update Date: | 04/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 39000953A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |