Provider Demographics
NPI:1437303781
Name:ZIMMERMAN, CAROL R (MFT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:R
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WESTMINSTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2832
Mailing Address - Country:US
Mailing Address - Phone:585-244-7277
Mailing Address - Fax:
Practice Address - Street 1:240 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2832
Practice Address - Country:US
Practice Address - Phone:585-244-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000420-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health