Provider Demographics
NPI:1962927590
Name:ANDREW ZIMMERMAN LCSW PLLC
Entity type:Organization
Organization Name:ANDREW ZIMMERMAN LCSW PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:888-517-4992
Mailing Address - Street 1:138 MACON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2205
Mailing Address - Country:US
Mailing Address - Phone:888-517-4992
Mailing Address - Fax:252-377-4231
Practice Address - Street 1:252 JAVA ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5424
Practice Address - Country:US
Practice Address - Phone:888-517-4992
Practice Address - Fax:252-377-4231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty