Provider Demographics
NPI:1528408911
Name:HERRIN, ZACHARY ROBERT (LPC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ROBERT
Last Name:HERRIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 S BROADWAY AVE
Mailing Address - Street 2:STE 820
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5227
Mailing Address - Country:US
Mailing Address - Phone:903-561-8995
Mailing Address - Fax:903-561-8895
Practice Address - Street 1:7925 S BROADWAY AVE
Practice Address - Street 2:STE 820
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5227
Practice Address - Country:US
Practice Address - Phone:903-561-8995
Practice Address - Fax:903-561-8895
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional