Provider Demographics
NPI:1306049150
Name:ZUFALL, JOHN MELVILLE (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MELVILLE
Last Name:ZUFALL
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 1:865 BULLS HEAD RD
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-2954
Mailing Address - Country:US
Mailing Address - Phone:225-281-3138
Mailing Address - Fax:
Practice Address - Street 1:5618 SUPERIOR DR
Practice Address - Street 2:SUITE H
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-6065
Practice Address - Country:US
Practice Address - Phone:225-281-3138
Practice Address - Fax:225-763-9568
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61571041C0700X
MS95601041C0700X
NY0968181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical