Provider Demographics
NPI:1578383220
Name:HEATHER ZUKOWSKI, LCSW, PLLC
Entity type:Organization
Organization Name:HEATHER ZUKOWSKI, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:716-795-7291
Mailing Address - Street 1:40 GARDENVILLE PKWY W STE 208
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1399
Mailing Address - Country:US
Mailing Address - Phone:716-795-7291
Mailing Address - Fax:
Practice Address - Street 1:40 GARDENVILLE PKWY W STE 208
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1399
Practice Address - Country:US
Practice Address - Phone:716-795-7291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty