Active NPI
Kimberly Anne Bonanno, LCSWR
- Clinical Social Worker
- Wappingers Falls, NY
National Provider Identifier
1013280783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 075692R
- Practice address
- 95 Brothers Rd
Wappingers Falls, NY 12590-3639 - Phone
- (845) 702-6989
- NPI assigned
- Feb 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 075692R | NY | Primary |
Addresses
Primary practice location
95 Brothers Rd
Wappingers Falls, NY 12590-3639
Mailing address
95 Brothers Rd
Wappingers Falls, NY 12590-3639
Phone (845) 702-6989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075692R | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1013280783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 BROTHERS RD",
"city": "WAPPINGERS FALLS",
"state": "NY",
"postal_code": "125903639",
"telephone_number": "845-702-6989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 BROTHERS RD",
"city": "WAPPINGERS FALLS",
"state": "NY",
"postal_code": "125903639",
"telephone_number": "845-702-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONANNO",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"name_prefix": "Miss",
"credential": "LCSWR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-10",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "075692R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wappingers Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.