Healthcare Provider Details

I. General information

NPI: 1194155226
Provider Name (Legal Business Name): MICHAEL ZIMMERMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date: 07/08/2020
Reactivation Date: 06/18/2021

III. Provider practice location address

2539 MONROEVILLE BLVD
MONROEVILLE PA
15146-2328
US

IV. Provider business mailing address

731 BLUE RIDGE RD
PITTSBURGH PA
15239-2848
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-2129
  • Fax:
Mailing address:
  • Phone: 412-592-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW019034
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: