Provider Demographics
NPI:1184348757
Name:ZIMINSKI, CAROLYN ALICE (LMHC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ALICE
Last Name:ZIMINSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7795 COLEE COVE RD
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-2301
Mailing Address - Country:US
Mailing Address - Phone:904-885-6343
Mailing Address - Fax:
Practice Address - Street 1:175 HAMPTON POINT DR STE 2
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3119
Practice Address - Country:US
Practice Address - Phone:904-885-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health