MEDICARE: SHELBY ZIMMERMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1417819905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY ZIMMERMAN

Provider Business Mailing Address
First Line	:	725 CRESSA DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-6051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 REDWING RD STE 150
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6314
Country	:	US
Telephone Number	:	970-464-3607
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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