Provider Demographics
NPI:1447484316
Name:ZANKER, JAMES AUGUST (MA, LPC, NCC, LCAS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:AUGUST
Last Name:ZANKER
Suffix:
Gender:M
Credentials:MA, LPC, NCC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 WINSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2706
Mailing Address - Country:US
Mailing Address - Phone:910-791-4478
Mailing Address - Fax:910-251-1040
Practice Address - Street 1:321 N FRONT ST
Practice Address - Street 2:SUITE 214
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3908
Practice Address - Country:US
Practice Address - Phone:910-791-4478
Practice Address - Fax:910-251-1040
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1435101YA0400X
NC6971101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104389Medicaid