Provider Demographics
NPI:1487012050
Name:ZIMMER, DAVID M (LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:ZIMMER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14015 SANFORD AVE STE B
Mailing Address - Street 2:STE 2
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2688
Mailing Address - Country:US
Mailing Address - Phone:718-651-7770
Mailing Address - Fax:
Practice Address - Street 1:3501 UNION ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3405
Practice Address - Country:US
Practice Address - Phone:718-888-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008585101YM0800X
NYP00905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health