Provider Demographics
NPI:1215578463
Name:SANCHEZ, KIMBERLY R (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:SANCHEZ
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 1:40 EXCHANGE PL STE 510
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-2775
Mailing Address - Country:US
Mailing Address - Phone:917-960-3548
Mailing Address - Fax:
Practice Address - Street 1:40 EXCHANGE PL STE 510
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-2775
Practice Address - Country:US
Practice Address - Phone:917-960-3548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0858821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical