Organization
DR. TIFFANY ZACHERY, LLC
Active
Organization
DR. TIFFANY ZACHERY, LLC
Active
Other names
Dr. Tiffany Zachery, LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY SHARELL ZACHERY LCSW (OWNER)
(337) 290-9868
Entity
Organization
Contact information
Practice address
110 TRAVIS STREET, SUITE 113, LAFAYETTE, LA 70503-2452
(225) 614-2757
Mailing address
PO BOX 62506, LAFAYETTE, LA 70596-2506
(337) 290-9868
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11337
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033690102
MEDICARE
LA
05
—
1033690102
—
LA
Enumeration date
01/14/2019
Last updated
01/14/2019
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