Provider Demographics
NPI:1831153253
Name:ZARA, ANDREA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:ZARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PFOUTS ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-3116
Mailing Address - Country:US
Mailing Address - Phone:570-829-2294
Mailing Address - Fax:570-829-2294
Practice Address - Street 1:5 PFOUTS ST
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-3116
Practice Address - Country:US
Practice Address - Phone:570-829-0795
Practice Address - Fax:570-829-2294
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACERT #2035101YA0400X
PACW0163761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW2118778OtherCIGNA BEHAVIORL HEALTH