Provider Demographics
NPI:1043363302
Name:ZINGALE, SALVATORE (PHD)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:ZINGALE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WEATHERBY DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2408
Mailing Address - Country:US
Mailing Address - Phone:931-801-5948
Mailing Address - Fax:931-358-5805
Practice Address - Street 1:130 HILLCREST DR
Practice Address - Street 2:SUITE 112
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5000
Practice Address - Country:US
Practice Address - Phone:931-551-8400
Practice Address - Fax:931-358-5805
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1143103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3682012Medicare ID - Type Unspecified