Provider Demographics
NPI:1285394361
Name:ZANIN, BRIAN (LPC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:ZANIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-1672
Mailing Address - Country:US
Mailing Address - Phone:262-207-4197
Mailing Address - Fax:262-458-2680
Practice Address - Street 1:1173 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-1672
Practice Address - Country:US
Practice Address - Phone:262-207-4197
Practice Address - Fax:262-458-2680
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10508101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional