Individual provider Active NPI

Michele Andree Zimmer-Forster, LCSW, LICSW, CSW-G

  • Clinical Social Worker
  • Potomac Falls, VA
National Provider Identifier
1902062078
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006139 Issued in VA
Practice address
20522 Falcons Landing Cir
Potomac Falls, VA 20165-7595
Phone
(703) 404-5116
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006139 VA Primary
Clinical Social Worker 1041C0700X LC50078042 DC

Addresses

Primary practice location

20522 Falcons Landing Cir
Potomac Falls, VA 20165-7595

Mailing address

10104 Walker Lake Dr
Great Falls, VA 22066-3502
Phone (703) 757-0529

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006139VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1902062078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10104 WALKER LAKE DR",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220663502",
            "telephone_number": "703-757-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20522 FALCONS LANDING CIR",
            "city": "POTOMAC FALLS",
            "state": "VA",
            "postal_code": "201657595",
            "telephone_number": "703-404-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER-FORSTER",
        "first_name": "MICHELE",
        "middle_name": "ANDREE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LICSW, CSW-G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006139",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac Falls, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.