Provider Demographics
NPI:1891561080
Name:ZARA GARRY, LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type:Organization
Organization Name:ZARA GARRY, LICENSED CLINICAL SOCIAL WORKER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-319-8586
Mailing Address - Street 1:150 S GLENOAKS BLVD # 9161
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1314
Mailing Address - Country:US
Mailing Address - Phone:818-319-8586
Mailing Address - Fax:
Practice Address - Street 1:1216 SPAZIER AVE UNIT A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1322
Practice Address - Country:US
Practice Address - Phone:818-319-8586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty