Individual
JENNIFER NICOLE ZACKASEE
Active
Individual
JENNIFER NICOLE ZACKASEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, MSW, CDCA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.174489
OH
1041C0700X
Clinical Social Worker
Primary
S.2106420
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
08/04/2021
Last updated
08/04/2021
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