Provider Demographics
NPI:1154449593
Name:ZIMMERMAN, LINDA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 ROMERO RD
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7624
Mailing Address - Country:US
Mailing Address - Phone:505-866-9271
Mailing Address - Fax:
Practice Address - Street 1:79 ROMERO RD
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7624
Practice Address - Country:US
Practice Address - Phone:505-866-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health