Basic Information
| Provider Information | |||||||||
| NPI: | 1811215940 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZIMNIEWICZ | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW, RN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HANEY | ||||||||
| OtherFirstName: | HELEN | ||||||||
| OtherMiddleName: | B | ||||||||
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| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1020 LAKE SUMTER LNDG | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321622699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526748905 | ||||||||
| FaxNumber: | 3526748919 | ||||||||
| Practice Location | |||||||||
| Address1: | 2485 PINELLAS PL | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321632703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526741720 | ||||||||
| FaxNumber: | 3526748920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2010 | ||||||||
| LastUpdateDate: | 09/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 9867 | FL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 163W00000X | RN 9253362 | FL | N | Nursing Service Providers | Registered Nurse |
No ID Information.