Provider Demographics
NPI:1386005213
Name:MARK ZIMMERMANN, LCSW, PLLC
Entity type:Organization
Organization Name:MARK ZIMMERMANN, LCSW, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:MUELLER
Authorized Official - Last Name:ZIMMERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-830-3463
Mailing Address - Street 1:4710 ELM ST APT W1304
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3828
Mailing Address - Country:US
Mailing Address - Phone:917-839-3463
Mailing Address - Fax:
Practice Address - Street 1:4710 ELM ST APT W1304
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3828
Practice Address - Country:US
Practice Address - Phone:917-830-3463
Practice Address - Fax:347-715-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-20
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0818451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty