Provider Demographics
NPI:1952513525
Name:ZIMMERMAN, NATALIE GREENLEAF (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:GREENLEAF
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HALLOWELL RD
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-8649
Mailing Address - Country:US
Mailing Address - Phone:610-754-6370
Mailing Address - Fax:610-754-6370
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:301-643-3638
Practice Address - Fax:301-652-9051
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD029821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS36297Medicare ID - Type Unspecified