Provider Demographics
NPI:1144367608
Name:ZIMMER, DUSTI BREE (LCSW)
Entity type:Individual
Prefix:
First Name:DUSTI
Middle Name:BREE
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DUSTI
Other - Middle Name:BREE
Other - Last Name:EKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-0522
Mailing Address - Country:US
Mailing Address - Phone:406-868-9533
Mailing Address - Fax:406-403-0381
Practice Address - Street 1:410 CENTRAL AVE STE 319
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3128
Practice Address - Country:US
Practice Address - Phone:406-868-9533
Practice Address - Fax:406-403-0381
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-7791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000071775OtherBLUE CROSS-SHIELD OF MONT
MTM011001330Medicare PIN
MT0000071775OtherBLUE CROSS-SHIELD OF MONT