Provider Demographics
NPI:1174863823
Name:ZIKMUND-FISHER, NAOMI (LMSW)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:
Last Name:ZIKMUND-FISHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 WASHTENAW RD UPPR LEVEL
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1889
Mailing Address - Country:US
Mailing Address - Phone:517-879-0938
Mailing Address - Fax:
Practice Address - Street 1:2048 WASHTENAW RD UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1889
Practice Address - Country:US
Practice Address - Phone:517-879-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094347104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker