Leifson, Zachary Albert

Leifson, Zachary Albert is an sole proprietor health care provider with primary practice located at 5685 S 1475 E #3B, South Ogden UT 84403. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Leifson, Zachary Albert can be contacted via phone (801) 582-1565.

Contact Information

Primary practice address
5685 S 1475 E #3B South Ogden UT 84403
Phone: (801) 582-1565
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6856471-3501 Utah
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1245557792
LBN Legal business name Leifson, Zachary Albert
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2010
Last updated Dec 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245557792 NPPES
Utah MEDICAID 1245557792

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