Provider Demographics
NPI:1700286721
Name:NANNETTE NERO ZUKE, LMFT, LLC
Entity type:Organization
Organization Name:NANNETTE NERO ZUKE, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER, MGR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NERO ZUKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CAGS, LMFT
Authorized Official - Phone:207-985-5580
Mailing Address - Street 1:3 BOYNTON BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9379
Mailing Address - Country:US
Mailing Address - Phone:207-985-5580
Mailing Address - Fax:
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:SUITE 6
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6650
Practice Address - Country:US
Practice Address - Phone:207-985-5580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMF1940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty