Provider Demographics
NPI:1043550304
Name:ZAKARAS, LAUREN SUZANNE (LCSW, DBH)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SUZANNE
Last Name:ZAKARAS
Suffix:
Gender:F
Credentials:LCSW, DBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16398 LANCASTER CV
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3699
Mailing Address - Country:US
Mailing Address - Phone:765-720-3730
Mailing Address - Fax:
Practice Address - Street 1:15465 OAK LN
Practice Address - Street 2:STE. D
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2663
Practice Address - Country:US
Practice Address - Phone:765-720-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC78521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical