MEDICARE: KIYANA ZACHERY LMFT, MAFP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	L725	AL
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1194475186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIYANA ZACHERY LMFT, MAFP

Provider Business Mailing Address
First Line	:	4171 LOMAC ST STE F
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2945
Country	:	US
Telephone Number	:	404-955-7296
Fax Number	:

Provider Business Practice Location Address
First Line	:	4171 LOMAC ST STE F
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2945
Country	:	US
Telephone Number	:	404-955-7296
Fax Number	:	404-955-7296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	04/14/2026

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