Provider Demographics
NPI:1073630091
Name:GIAMBRUNI, KIM (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:
Last Name:GIAMBRUNI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E END AVE
Mailing Address - Street 2:#10M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7831
Mailing Address - Country:US
Mailing Address - Phone:212-996-3619
Mailing Address - Fax:
Practice Address - Street 1:1327 LEXINGTON AVE
Practice Address - Street 2:SUITE #1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1109
Practice Address - Country:US
Practice Address - Phone:212-996-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO36549174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist