Ida Zektick Zack PHD PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301001930 Issued in MI

Legal business name

IDA ZEKTICK ZACK PHD PLLC

Practice address

217 Knowles St
Suite 100
Royal Oak, MI 48067-2767

Phone

(248) 546-6711

Fax

(248) 546-5090

NPI assigned

Jun 10, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ida Zack, PH.D.

Title

Psychologist

Phone

(248) 546-6711

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1124348362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 KNOWLES ST",
            "address_2": "SUITE 100",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672767",
            "telephone_number": "248-546-6711",
            "fax_number": "248-546-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 KNOWLES ST",
            "address_2": "SUITE 100",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672767",
            "telephone_number": "248-546-6711",
            "fax_number": "248-546-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA ZEKTICK ZACK PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "ZACK",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-546-6711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahnoor Ibadat, ACNPC-AG
• Abdalla Khalil Ibrahim, MD, PHD
• Amjad Ibrahim
• Mohammed Ibrahim, MD
• Ragheda Ibrahim
• Jay Idler
• Jennifer R Idrissu, NP
• Alexandria L Idziak
• Hira Iftikhar, MD
• Maureen Nkolika Ikedinobi-Ndi, MD

• Clinical Psychologist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.