Provider Demographics
NPI:1053528190
Name:LOOMIS, LEANN ZAVOTKA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:ZAVOTKA
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 MIDDLETOWN HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROWE
Mailing Address - State:MA
Mailing Address - Zip Code:01367-9702
Mailing Address - Country:US
Mailing Address - Phone:413-339-8573
Mailing Address - Fax:
Practice Address - Street 1:55 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2546
Practice Address - Country:US
Practice Address - Phone:413-772-2935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health