Zak, Dawn M
Zak, Dawn M is an individual health care provider with primary practice located at 1777 W Grand Ave , Port Washington WI 53074-2077. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Zak, Dawn M can be contacted via phone (262) 268-6637.Contact Information
Primary practice address
1777 W Grand Ave
Port Washington WI 53074-2077
Phone: (262) 268-6637
Fax: (262) 268-6615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 5924-125 | Wisconsin |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1321 | Wisconsin |
Profile Details
| NPI number | 1356332464 |
|---|---|
| LBN Legal business name | Zak, Dawn M |
| Credentials | MS, LPC, CSAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Jun 21st, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356332464 | NPPES |
| Wisconsin | MEDICAID | 42138800 |
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