Provider Demographics
NPI:1417329590
Name:RITA L ZIMMER, LLC
Entity Type:Organization
Organization Name:RITA L ZIMMER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMHC
Authorized Official - Phone:239-671-0241
Mailing Address - Street 1:1137 SW 16TH TER
Mailing Address - Street 2:1-D
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3267
Mailing Address - Country:US
Mailing Address - Phone:239-671-0241
Mailing Address - Fax:239-549-5648
Practice Address - Street 1:615 CAPE CORAL PKWY W
Practice Address - Street 2:SUITE 201
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6571
Practice Address - Country:US
Practice Address - Phone:239-671-0241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty