Provider Demographics
NPI:1730880741
Name:ZION THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:ZION THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DORETHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DELRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:586-420-0880
Mailing Address - Street 1:21366 HALL RD # 1059
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1539
Mailing Address - Country:US
Mailing Address - Phone:586-420-0880
Mailing Address - Fax:
Practice Address - Street 1:20512 HARMONY DRIVE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-4803
Practice Address - Country:US
Practice Address - Phone:586-420-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)