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NPI Code Detail

MEDICARE: JESSICA A. ZIMMERMAN LMHC LLC

MEDICARE: JESSICA A. ZIMMERMAN LMHC LLC
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
1251S00000XCommunity/Behavioral Health Agency39001854AIN

General Provider Information

NPI Number : 1205093960
Entity Type Code : Organization
Provider Name (Legal Business Name) : JESSICA A. ZIMMERMAN LMHC LLC
Provider Business Mailing Address
First Line : 6530 CONSTITUTION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1550
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6530 CONSTITUTION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1550
Country : US
Telephone Number : 260-414-2690
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JESSICA A. ZIMMERMAN
Credential : M.ED, LMHC
Telephone Number : 260-414-2690
Provider Enumeration Date : 05/20/2008
Last Update Date : 05/20/2008

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Directions to “JESSICA A. ZIMMERMAN LMHC LLC ” Practice Location

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