Provider Demographics
NPI:1467835207
Name:WIMER, ANN MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:WIMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3489 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9461
Mailing Address - Country:US
Mailing Address - Phone:616-416-4030
Mailing Address - Fax:
Practice Address - Street 1:3489 PALMER DR
Practice Address - Street 2:
Practice Address - City:SAUGATUCK
Practice Address - State:MI
Practice Address - Zip Code:49453-9461
Practice Address - Country:US
Practice Address - Phone:616-416-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW709071041C0700X
MI6801109601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical