Healthcare Provider Details

I. General information

NPI: 1396429833
Provider Name (Legal Business Name): ZACHARY MCMASTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 MAXWELL RD STE 100
ALPHARETTA GA
30009-2031
US

IV. Provider business mailing address

PO BOX 844387
DALLAS TX
75284-4387
US

V. Phone/Fax

Practice location:
  • Phone: 404-388-3909
  • Fax:
Mailing address:
  • Phone: 404-388-3909
  • Fax: 678-712-1945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC017232
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC017232
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: