MEDICARE: BRIGITTE ZYLAROCH

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	104100000X	Social Worker	109011-01	NY
2	1041C0700X	Clinical Social Worker	C015612	NC

General Provider Information

NPI Number	:	1902430804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIGITTE ZYLAROCH

Provider Business Mailing Address
First Line	:	1105 TRYON VILLAGE DR
Second Line	:	STE 303 #1046
City	:	RALEIGH
State	:	NC
Zip	:	27518-7170
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7404 CHAPEL HILL RD STE A
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5043
Country	:	US
Telephone Number	:	984-664-3203
Fax Number	:

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

Provider Enumeration Date	:	02/28/2020
Last Update Date	:	12/17/2024

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