Provider Demographics
NPI:1326609579
Name:ZAHKA, GLORIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:ZAHKA
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PINE TREE RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-9438
Mailing Address - Country:US
Mailing Address - Phone:802-291-2606
Mailing Address - Fax:
Practice Address - Street 1:295 MAIN ST # E210
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9321
Practice Address - Country:US
Practice Address - Phone:802-291-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health