Jay Louis Cimmer, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35001529A Issued in IN

Practice address

30 W Indiana Ave
Bloomfield, IN 47424-1200

Phone

(812) 384-3946

Fax

(812) 384-3948

NPI assigned

Dec 1, 2005

Last updated

Aug 21, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1669456760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 E BILL MALLORY BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018635",
            "telephone_number": "812-322-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W INDIANA AVE",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474241200",
            "telephone_number": "812-384-3946",
            "fax_number": "812-384-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMMER",
        "first_name": "JAY",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "35001529A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001529A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000330621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Bloomfield, IN
• Providers in Bloomfield, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.