Provider Demographics
NPI:1023611860
Name:KIMMELMAN, JANE ZVI (LMSW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:ZVI
Last Name:KIMMELMAN
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 1:9 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1701
Mailing Address - Country:US
Mailing Address - Phone:973-818-1925
Mailing Address - Fax:
Practice Address - Street 1:7 W 30TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4406
Practice Address - Country:US
Practice Address - Phone:212-725-7850
Practice Address - Fax:212-967-4919
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health