Individual
MR. JUSTIN DEAN ZIERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC, NCC, ACADC
Contact information
Practice address
1070 HILINE RD STE 210, POCATELLO, ID 83201-2947
(208) 821-1384
(208) 478-4999
Mailing address
281 HUMMINGBIRD CIR, SHELLEY, ID 83274-5099
(208) 821-1384
(208) 478-4999
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
160
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
205596
ID
101YM0800X
Mental Health Counselor
Primary
LCPC-4875
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497081681
—
ID
Enumeration date
10/23/2009
Last updated
12/14/2011
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