Provider Demographics
NPI:1720340631
Name:ZIMBRICH, EMILY (LPC; CDCII)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ZIMBRICH
Suffix:
Gender:F
Credentials:LPC; CDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BEACH RD
Mailing Address - Street 2:BOX 888
Mailing Address - City:HAINES
Mailing Address - State:AK
Mailing Address - Zip Code:99827-1549
Mailing Address - Country:US
Mailing Address - Phone:907-766-6380
Mailing Address - Fax:907-766-6320
Practice Address - Street 1:77 BEACH RD.
Practice Address - Street 2:
Practice Address - City:HAINES
Practice Address - State:AK
Practice Address - Zip Code:99827
Practice Address - Country:US
Practice Address - Phone:907-766-6380
Practice Address - Fax:907-766-6320
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2529101YA0400X
AK361101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)