Individual ProviderTiffany Sharell ZacherySocial WorkerBehavioral Health & Social Service ProvidersPractice Address110 Travis St Ste 113, Lafayette, LA 70503-2453(225) 614-2757(337) 290-9868PECOS EnrollmentBased on the most recent information from CMS, provider Tiffany Sharell Zachery does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1033690102Provider TypeIndividualFull NameZachery, Tiffany SharellTitleMs.CredentialLCSW, PHDGenderFemaleSole ProprietorNoEnumeration Date8/27/2018Last Updated1/13/2019Contact InformationPractice LocationPractice Address110 Travis St Ste 113, Lafayette, LA 70503-2453Phone(225) 614-2757FaxUnlisted FaxMailing LocationMailing AddressPO Box 62506, Lafayette, LA 70596-2506Phone(337) 290-9868FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense11337LouisianaProvider IdentifiersIDDescriptionIssuerID1033690102DescriptionMedicaidIssuerUnlistedLouisiana