Provider Demographics
NPI:1811518855
Name:EFAW, ZACHARY SCOTT (CT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:SCOTT
Last Name:EFAW
Suffix:
Gender:M
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DORCHESTER SQ N STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7305
Mailing Address - Country:US
Mailing Address - Phone:614-890-8262
Mailing Address - Fax:
Practice Address - Street 1:100 DORCHESTER SQ N STE 102
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7305
Practice Address - Country:US
Practice Address - Phone:614-890-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002377-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health