NEURODIVERSE THERAPY, LLC
NPI 1255020368
Social Worker in Fort Knox, KY
About Neurodiverse Therapy, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NEURODIVERSE THERAPY, LLC (NPI 1255020368) is a healthcare organization registered as a social worker in Fort Knox, Kentucky and active in the NPI registry since May 2023. The organization lists Stacey Zimmerman, Lcsw/ Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Neurodiverse Therapy, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Neurodiverse Therapy, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Neurodiverse Therapy, LLC's NPI number?
The NPI number for Neurodiverse Therapy, LLC is 1255020368. It was assigned to this organization in the NPPES registry on May 4, 2023.
Where is Neurodiverse Therapy, LLC located?
Neurodiverse Therapy, LLC is located at 209 Willow Ave, Fort Knox, KY 40121. The listed phone number is (561) 414-6016.
What is Neurodiverse Therapy, LLC's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Neurodiverse Therapy, LLC enrolled in Medicare?
Yes. Neurodiverse Therapy, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Neurodiverse Therapy, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Neurodiverse Therapy, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Neurodiverse Therapy, LLC was last updated on May 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Neurodiverse Therapy, Llc · NPI 1255020368
Social Worker organization in Fort Knox, Kentucky. Organization record, active in the CMS NPPES registry since May 4, 2023.
## Identity
- **NPI:** 1255020368 (Entity type: Organization)
- **Enumerated:** May 4, 2023
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **Organization subpart:** No
- **Authorized official:** Stacey Zimmerman, LCSW/ OWNER
## Practice location
- **Address:** 209 WILLOW AVE, Fort Knox, KY 40121-4513
- **Phone:** (561) 414-6016
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 4, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1255020368) · Data from the CMS NPPES public registry.