Provider Demographics
NPI:1205676905
Name:O'HOLLEARN, ZACHARY THOMAS (LMSW)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:THOMAS
Last Name:O'HOLLEARN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1436
Mailing Address - Country:US
Mailing Address - Phone:515-276-6338
Mailing Address - Fax:
Practice Address - Street 1:1730 28TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1436
Practice Address - Country:US
Practice Address - Phone:515-276-6338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1246641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical