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General NPI Number Information
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NPI Number | 1578201877
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Entity Type | Individual
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Provider Name | EVAN WILLIAM ZIMDARS LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 17940 FARMINGTON RD STE 302
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City | LIVONIA
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State | MI
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Zip | 48152-3159
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Country | US
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Telephone | 734-679-2951
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Fax |
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Provider Business Mailing Address
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Address Line | 220 HICKORY LN APT 204
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City | WESTLAND
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State | MI
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Zip | 48185-3452
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Country | US
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Telephone | 734-679-2951
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851114500
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801120107
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License Number State | MI
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