Provider Demographics
NPI:1730185349
Name:ZELEK, ANITA LATONA (LCSW)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:LATONA
Last Name:ZELEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4535 HARDING RD
Mailing Address - Street 2:STE 210
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2120
Mailing Address - Country:US
Mailing Address - Phone:615-383-0095
Mailing Address - Fax:615-383-0189
Practice Address - Street 1:4535 HARDING RD
Practice Address - Street 2:STE 210
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2120
Practice Address - Country:US
Practice Address - Phone:615-383-0095
Practice Address - Fax:615-383-0189
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3692428Medicare ID - Type UnspecifiedMEDICARE NUMBER