Healthcare Provider Details

I. General information

NPI: 1598626913
Provider Name (Legal Business Name): KELLY MARILYN ZHUMI-CHIMBAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PH
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

33 DANK CT APT 2
BROOKLYN NY
11223-6122
US

V. Phone/Fax

Practice location:
  • Phone: 212-696-4717
  • Fax:
Mailing address:
  • Phone: 347-825-4121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: