Provider Demographics
NPI:1285859181
Name:WILLIAMS-ZIMMERMAN, RANDI LAUREN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:LAUREN
Last Name:WILLIAMS-ZIMMERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 TOFTREE CT
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3081
Mailing Address - Country:US
Mailing Address - Phone:516-869-5306
Mailing Address - Fax:516-869-5226
Practice Address - Street 1:135 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3031
Practice Address - Country:US
Practice Address - Phone:516-692-4455
Practice Address - Fax:516-869-5226
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0742301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical