Provider Demographics
NPI:1891478541
Name:KIMMEL, MOLLY (LMSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:KIMMEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 WARREN ST APT 6B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10282-0009
Mailing Address - Country:US
Mailing Address - Phone:914-715-4518
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4564
Practice Address - Country:US
Practice Address - Phone:914-715-4518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0993551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical