Provider Demographics
NPI:1194475186
Name:ZACHERY, KIYANA (LMFT-A, MAFP)
Entity type:Individual
Prefix:
First Name:KIYANA
Middle Name:
Last Name:ZACHERY
Suffix:
Gender:F
Credentials:LMFT-A, MAFP
Other - Prefix:
Other - First Name:KIYANA
Other - Middle Name:
Other - Last Name:MCCRORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT-A, MAFP
Mailing Address - Street 1:2414 BELCHER DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2127
Mailing Address - Country:US
Mailing Address - Phone:404-955-7296
Mailing Address - Fax:
Practice Address - Street 1:1070 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTERDALE
Practice Address - State:GA
Practice Address - Zip Code:30014-3439
Practice Address - Country:US
Practice Address - Phone:404-955-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)