Provider Demographics
NPI:1023402716
Name:ZIMMERMAN, EMILY (LSW, LMSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 HUDSON AVE
Mailing Address - Street 2:APARTMENT 3C
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2158
Mailing Address - Country:US
Mailing Address - Phone:908-902-9069
Mailing Address - Fax:
Practice Address - Street 1:131 HUDSON AVE
Practice Address - Street 2:APARTMENT 3C
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2158
Practice Address - Country:US
Practice Address - Phone:908-902-9069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05934700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker