OrganizationDr. Tiffany Zachery, Llc(Dr. Tiffany Zachery, Lcsw)Social WorkerBehavioral Health & Social Service ProvidersPractice Address110 Travis Street, Suite 113, Lafayette, LA 70503-2452(225) 614-2757(337) 290-9868PECOS EnrollmentBased on the most recent information from CMS, provider Dr. Tiffany Zachery, Llc 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 today at 11:47 AM.Profile DetailsProvider ID1619441565Provider TypeOrganizationFull NameDr. Tiffany Zachery, LlcOther NameDr. Tiffany Zachery, LcswSubpartNoEnumeration Date1/14/2019Last Updated1/14/2019Contact InformationPractice LocationPractice Address110 Travis Street, Suite 113, Lafayette, LA 70503-2452Phone(225) 614-2757FaxUnlisted FaxMailing LocationMailing AddressPO Box 62506, Lafayette, LA 70596-2506Phone(337) 290-9868FaxUnlisted FaxAuthorized OfficialNameZachery, Tiffany Sharell (Owner)Phone(337) 290-9868Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense11337LouisianaProvider IdentifiersIDDescriptionIssuerID1033690102DescriptionMedicaidIssuerUnlistedLouisianaID1033690102DescriptionOtherIssuerMEDICARELouisiana