Provider Demographics
NPI:1891495479
Name:BULLARD, ZACHARY CLARKE (LCMHCA)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CLARKE
Last Name:BULLARD
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601B LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5510
Mailing Address - Country:US
Mailing Address - Phone:910-276-7011
Mailing Address - Fax:910-276-7060
Practice Address - Street 1:601B LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5510
Practice Address - Country:US
Practice Address - Phone:910-276-7011
Practice Address - Fax:910-276-7060
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health