Provider Demographics
NPI:1194874511
Name:ZAKRZEWSKI, THOMAS JOHN (LCSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:ZAKRZEWSKI
Suffix:
Gender:M
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:MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT
Mailing Address - Street 2:926 S 8TH STREET
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54221-1177
Mailing Address - Country:US
Mailing Address - Phone:920-683-4230
Mailing Address - Fax:920-720-3806
Practice Address - Street 1:MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT
Practice Address - Street 2:926 S 8TH STREET
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54221-1177
Practice Address - Country:US
Practice Address - Phone:920-683-4230
Practice Address - Fax:920-720-3806
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0116351041C0700X
WI74521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932561OtherBCBS PPO