Provider Demographics
NPI:1356663850
Name:ZEMO, KIMBERLY M (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:ZEMO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2625
Mailing Address - Country:US
Mailing Address - Phone:203-610-4607
Mailing Address - Fax:
Practice Address - Street 1:5893 MAIN ST
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-2448
Practice Address - Country:US
Practice Address - Phone:203-268-8852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0061431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical