Provider Demographics
NPI:1912037086
Name:ZIMMERMAN, PAUL THOMAS (LCSW,CAP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:LCSW,CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 W PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2519
Mailing Address - Country:US
Mailing Address - Phone:954-731-1000
Mailing Address - Fax:954-497-3857
Practice Address - Street 1:2900 W PROSPECT RD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2519
Practice Address - Country:US
Practice Address - Phone:954-731-1000
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW37561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical