Active NPI
Kim L. Zuckerman, LMHC
- Mental Health Counselor
- Lawrenceville, GA
National Provider Identifier
1295758985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH7201
- Practice address
- 1679 Hickory Wood CT
Lawrenceville, GA 30043-3560 - Phone
- (561) 252-4097
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH7201 | FL | Primary |
| Mental Health Counselor | 101YM0800X | LPC005527 | GA |
Addresses
Primary practice location
1679 Hickory Wood CT
Lawrenceville, GA 30043-3560
Mailing address
1679 Hickory Wood CT
Lawrenceville, GA 30043-3560
Phone (561) 252-4097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 764235100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH7201 | FL | MD | Mental Health Counselor |
| LPC005527 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232064000000",
"number": "1295758985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1679 HICKORY WOOD CT",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300433560",
"telephone_number": "561-252-4097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1679 HICKORY WOOD CT",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300433560",
"telephone_number": "561-252-4097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUCKERMAN",
"first_name": "KIM",
"middle_name": "L.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2009-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH7201",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC005527",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "764235100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.