Provider Demographics
NPI:1649799305
Name:ZACKERU, WILLIAM S (LPCC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:ZACKERU
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9851 JEFFERSON PKWY APT D2
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5973
Mailing Address - Country:US
Mailing Address - Phone:908-285-5893
Mailing Address - Fax:
Practice Address - Street 1:19563 E MAINSTREET STE 206
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7394
Practice Address - Country:US
Practice Address - Phone:908-285-5893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health