Individual provider Active NPI

Jessica Zimmermann

  • Clinical Social Worker
  • Huntsville, AL
National Provider Identifier
1831696608
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3945C Issued in AL
Practice address
7800 Madison Blvd Ste 705
Huntsville, AL 35806-2049
Phone
(256) 617-3236
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3945C AL
Clinical Social Worker 1041C0700X 3945C AL Primary

Addresses

Primary practice location

7800 Madison Blvd Ste 705
Huntsville, AL 35806-2049

Mailing address

127 Mildred Way
Madison, AL 35756-4072
Phone (256) 617-3236

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

LicenseStateTypeSpecialty
3945CALMDMental Health Clinic/Center (Including Community Mental Health Center)

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Life Counseling Mental Health (Including Community Mental Health Center) CurrentSince Sep 13, 2020 Accepting new patients

Locations

7800 Madison Blvd
Ste 705
Huntsville, AL 35806
Phone (256) 617-3236

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1831696608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MILDRED WAY",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564072",
            "telephone_number": "256-617-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 MADISON BLVD STE 705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358062049",
            "telephone_number": "256-617-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AL",
            "license": "3945C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3945C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.