Provider Demographics
NPI:1184743742
Name:ZIMMERMAN, JILL SARAH (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:SARAH
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:SARAH
Other - Last Name:ZIMMERMAN RUTLEDGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-0177
Mailing Address - Country:US
Mailing Address - Phone:970-949-0404
Mailing Address - Fax:970-479-0731
Practice Address - Street 1:48 E. BEAVER CREEK BLVD.
Practice Address - Street 2:STE. 209
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-949-0404
Practice Address - Fax:970-479-0731
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0015471041C0700X
CO13181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical