Provider Demographics
NPI:1740978527
Name:ZINN, KELLY T (MA, DSW, LMSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:T
Last Name:ZINN
Suffix:
Gender:F
Credentials:MA, DSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LIBRARY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2664
Mailing Address - Country:US
Mailing Address - Phone:631-998-4644
Mailing Address - Fax:631-998-4645
Practice Address - Street 1:16 LIBRARY AVE STE B
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2664
Practice Address - Country:US
Practice Address - Phone:631-998-4644
Practice Address - Fax:631-998-4645
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical