Provider Demographics
NPI:1255119046
Name:ZIMMER, NATALIE KATHLEEN (LCMHC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:KATHLEEN
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:ZIMMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHC
Mailing Address - Street 1:92 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4525
Mailing Address - Country:US
Mailing Address - Phone:802-242-1382
Mailing Address - Fax:
Practice Address - Street 1:92 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4525
Practice Address - Country:US
Practice Address - Phone:802-242-1382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health