Active NPI
Heidi Zinzow, PH.D.
- Clinical Psychologist
- Clemson, SC
National Provider Identifier
1124353776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1097
- Practice address
- 400 College Ave Ste 4
Clemson, SC 29631-2925 - Phone
- (864) 656-4376
- NPI assigned
- Oct 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1097 | SC | Primary |
Addresses
Primary practice location
400 College Ave Ste 4
Clemson, SC 29631-2925
Mailing address
212 Cedar Dale Dr
Central, SC 29630-9499
Phone (864) 656-4376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1097 | SC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255478400000",
"number": "1124353776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 CEDAR DALE DR",
"city": "CENTRAL",
"state": "SC",
"postal_code": "296309499",
"telephone_number": "864-656-4376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 COLLEGE AVE STE 4",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296312925",
"telephone_number": "864-656-4376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZINZOW",
"first_name": "HEIDI",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-14",
"last_updated": "2009-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clemson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.