Avi-Natan Zadaka, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09928781 Issued in CO

Practice address

777 29TH St Ste 500
Boulder, CO 80303-2357

Phone

(763) 442-7238

NPI assigned

Dec 4, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1154927226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 WILLOUGHBY WAY E",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553055414",
            "telephone_number": "763-442-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 500",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032357",
            "telephone_number": "763-442-7238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADAKA",
        "first_name": "AVI-NATAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28038",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09928781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth F Yurth, MD
• Mark Hall Zacharewicz, PH.D.
• Alan Scott Zacharias, M.D.
• Eric Zacharias, M.D.
• Zachary Sussman
• Christine Andrea Zakar, P.A.-C.
• C Zakoian, LPC
• Corey Paul Zalewski, LMT
• Jorge Andres Zambrano Robledo, LPC MA
• Zandi Chiropractic, LLC

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.