Provider Demographics
NPI:1083421846
Name:VIRNIG, ZACHARY ARDEN HOOK (MA, LPCC)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ARDEN HOOK
Last Name:VIRNIG
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:ZACHARY
Other - Middle Name:A
Other - Last Name:VIRNIG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPCC
Mailing Address - Street 1:190 SAILSTAR DR NW
Mailing Address - Street 2:
Mailing Address - City:CASS LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56633-3565
Mailing Address - Country:US
Mailing Address - Phone:218-335-3050
Mailing Address - Fax:
Practice Address - Street 1:16123 61ST STREET NW
Practice Address - Street 2:
Practice Address - City:CASS LAKE
Practice Address - State:MN
Practice Address - Zip Code:56633-3360
Practice Address - Country:US
Practice Address - Phone:218-335-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health