Healthcare Provider Details

I. General information

NPI: 1831153253
Provider Name (Legal Business Name): ANDREA ZARA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PFOUTS ST
HANOVER TOWNSHIP PA
18706-3116
US

IV. Provider business mailing address

5 PFOUTS ST
HANOVER TOWNSHIP PA
18706-3116
US

V. Phone/Fax

Practice location:
  • Phone: 570-829-0795
  • Fax: 570-829-2294
Mailing address:
  • Phone: 570-829-2294
  • Fax: 570-829-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCERT #2035
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016376
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: