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Individual
ZACHARY ALBERT LEIFSON
Active
Individual
ZACHARY ALBERT LEIFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6856471-3501
UT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245557792
—
UT
Enumeration date
04/23/2010
Last updated
12/08/2016
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