Healthcare Provider Details

I. General information

NPI: 1740700319
Provider Name (Legal Business Name): ASSUMY GUMBS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 12/09/2023
Certification Date: 12/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HUGUENOT ST STE 330
NEW ROCHELLE NY
10801-5200
US

IV. Provider business mailing address

596 RIVERSIDE DR APT 2K
NEW YORK NY
10031-8038
US

V. Phone/Fax

Practice location:
  • Phone: 332-215-6631
  • Fax:
Mailing address:
  • Phone: 917-971-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number092097-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094947-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: