Provider Demographics
NPI:1689145831
Name:BYAM, ZACHARY CLARKE
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CLARKE
Last Name:BYAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 SYCAMORE DR APT 309
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-1939
Mailing Address - Country:US
Mailing Address - Phone:202-431-0829
Mailing Address - Fax:
Practice Address - Street 1:3 KENSINGTON SQ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6443
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health