Provider Demographics
NPI:1699388793
Name:STEARNS, ZACHARY DAVID (BS, BA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DAVID
Last Name:STEARNS
Suffix:
Gender:M
Credentials:BS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 US HIGHWAY 45 N
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930-3766
Mailing Address - Country:US
Mailing Address - Phone:618-273-3326
Mailing Address - Fax:618-273-2808
Practice Address - Street 1:1412 US HIGHWAY 45 N
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:IL
Practice Address - Zip Code:62930-3766
Practice Address - Country:US
Practice Address - Phone:618-273-3326
Practice Address - Fax:618-273-2808
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health