Provider Demographics
NPI:1417233826
Name:ZIMMERMANN, ELLEN PATRICE (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:PATRICE
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8803 BEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4408
Mailing Address - Country:US
Mailing Address - Phone:512-301-5878
Mailing Address - Fax:
Practice Address - Street 1:8803 BEAR CREEK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4408
Practice Address - Country:US
Practice Address - Phone:512-301-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-30
Last Update Date:2011-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health