Provider Demographics
NPI:1407830409
Name:ZIMMERMAN, SHEILA M (LMFT, LADC)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:M
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FABER AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-1829
Mailing Address - Country:US
Mailing Address - Phone:203-573-9581
Mailing Address - Fax:
Practice Address - Street 1:88 GRANDVIEW AVENUE
Practice Address - Street 2:GRANDVIEW AUDULT BEHAVIORAL HEALTH
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-573-7265
Practice Address - Fax:203-573-7578
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000628101YA0400X
CT000543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist