Provider Demographics
NPI:1710218086
Name:ZIMMERMAN, DONALD (LMHC, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:LMHC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 91ST ST
Mailing Address - Street 2:STE. 103
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1549
Mailing Address - Country:US
Mailing Address - Phone:317-705-9650
Mailing Address - Fax:317-705-9654
Practice Address - Street 1:50 E 91ST ST
Practice Address - Street 2:STE. 103
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1549
Practice Address - Country:US
Practice Address - Phone:317-705-9650
Practice Address - Fax:317-705-9654
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000529A101YM0800X
IN34003076A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical