Kristin Ellen Zimmerman, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0903003442 Issued in VA

Practice address

9675 Main St Ste C
Fairfax, VA 22031-3762

Phone

(703) 334-0409

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairfax Therapy Solutions LLC

  • Mental Health Counselor
  • Fairfax, VA
  • NPI 1902448251
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1265162002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 AVERY CT SW",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806448",
            "telephone_number": "571-551-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9675 MAIN ST STE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313762",
            "telephone_number": "703-334-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KRISTIN",
        "middle_name": "ELLEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0903003442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristi@fairfaxtherapysolutions.com",
            "affiliation": "N",
            "address_1": "9675 Main St Ste C",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220313762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lingyi Zhu
• Xiaolan Zhu, M.D.
• Nadia Zia
• Ahmad Z Ziaie, MD
• Henry Dearborn Ziegler, M.D.
• Mateo Ziu, MD
• Abeer Zletni
• Jason J Zodda
• Shahrzad Zonoozi
• Reza Zonozi, M.D.

• Mental Health Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.