Provider Demographics
NPI:1467412080
Name:ZIMMER, SHIRLEY F (ACSW)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:F
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38455 CHESSINGTON
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2864
Mailing Address - Country:US
Mailing Address - Phone:248-488-2185
Mailing Address - Fax:
Practice Address - Street 1:2314 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3045
Practice Address - Country:US
Practice Address - Phone:313-562-6633
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008953650OtherBLUE CROSS BLUE SHIELD
MIP86572Medicare ID - Type Unspecified