Individual
KIMBERLY M PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBA,MS
Contact information
Practice address
115 E 23RD ST FL 9, NEW YORK, NY 10010-4559
(347) 600-9463
Mailing address
723 ESSEX ST, BROOKLYN, NY 11208-4407
(646) 725-6271
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NY
103TB0200X
Cognitive & Behavioral Psychologist
—
NY
103TC1900X
Counseling Psychologist
—
NY
103TC2200X
Clinical Child & Adolescent Psychologist
—
NY
103TF0000X
Family Psychologist
—
NY
103TP2701X
Group Psychotherapy Psychologist
—
NY
251B00000X
Case Management Agency
—
NY
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZJ84485V
—
NY
Enumeration date
11/21/2021
Last updated
08/15/2023
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