Provider Demographics
NPI:1023643384
Name:ZEN PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:ZEN PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-403-0623
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-0248
Mailing Address - Country:US
Mailing Address - Phone:828-403-0623
Mailing Address - Fax:
Practice Address - Street 1:126 FIDDLERS RUN BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7753
Practice Address - Country:US
Practice Address - Phone:828-475-1183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1508885443Medicaid