Provider Demographics
NPI:1982333027
Name:TANIA ZUBKUS PSYCHOTHERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:TANIA ZUBKUS PSYCHOTHERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUBKUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-274-7945
Mailing Address - Street 1:1544 ASHLAND AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1175
Mailing Address - Country:US
Mailing Address - Phone:708-274-7945
Mailing Address - Fax:
Practice Address - Street 1:1544 ASHLAND AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1175
Practice Address - Country:US
Practice Address - Phone:708-274-7945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty