Provider Demographics
NPI:1538883988
Name:RANSOM, ZACHARY CLARK (LSW)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:CLARK
Last Name:RANSOM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 PENNSYLVANIA AVE W
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2238
Mailing Address - Country:US
Mailing Address - Phone:814-230-3042
Mailing Address - Fax:
Practice Address - Street 1:438 PENNSYLVANIA AVE W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2238
Practice Address - Country:US
Practice Address - Phone:814-230-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker