Individual
MR. ZAKERY R WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC4472
Contact information
Practice address
2705 E 17TH ST STE A, AMMON, ID 83406-6601
(208) 346-7500
(208) 346-7501
Mailing address
2705 E 17TH ST, AMMON, ID 83406-6601
(208) 346-7500
(208) 346-7501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4472
ID
1041C0700X
Clinical Social Worker
LPC3960
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002648300
—
ID
Enumeration date
01/16/2008
Last updated
02/15/2019
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