Provider Demographics
NPI:1902062078
Name:ZIMMER-FORSTER, MICHELE ANDREE (LCSW, LICSW, CSW-G)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:ANDREE
Last Name:ZIMMER-FORSTER
Suffix:
Gender:F
Credentials:LCSW, LICSW, CSW-G
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10104 WALKER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-3502
Mailing Address - Country:US
Mailing Address - Phone:703-757-0529
Mailing Address - Fax:
Practice Address - Street 1:20522 FALCONS LANDING CIR
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-7595
Practice Address - Country:US
Practice Address - Phone:703-404-5116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040061391041C0700X
DCLC500780421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical