Provider Demographics
NPI:1831230556
Name:ZISCHKE, SCOTT B (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:ZISCHKE
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 WEEPING WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-4446
Mailing Address - Country:US
Mailing Address - Phone:480-646-6094
Mailing Address - Fax:
Practice Address - Street 1:9101 WEEPING WILLOW CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-4446
Practice Address - Country:US
Practice Address - Phone:480-646-6094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106253235Z00000X
WALL00003425235Z00000X
AZSLP5666235Z00000X
CO00001574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8410813Medicaid