Provider Demographics
NPI:1669504015
Name:ZIMMERMAN, ROCHELLE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:S
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROCHELLE
Other - Middle Name:S
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:138 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3307
Mailing Address - Country:US
Mailing Address - Phone:267-697-9022
Mailing Address - Fax:
Practice Address - Street 1:NESHAMINY PLAZA 3070 BRISTOL PIKE
Practice Address - Street 2:BUILDING I SUITE 104 C
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5467
Practice Address - Country:US
Practice Address - Phone:267-697-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW013257L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39348Medicare ID - Type Unspecified
NYR28035Medicare UPIN