Individual provider Active NPI

Kimberly Hershenson, LCSW

  • Social Worker
  • New York, NY
National Provider Identifier
1104360841
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
097702-1 Issued in NY
Practice address
71 Park Ave Ste 1C
New York, NY 10016-2507
Phone
(267) 980-8704
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 088903 NY
Social Worker 104100000X 097702-1 NY Primary

Addresses

Primary practice location

71 Park Ave Ste 1C
New York, NY 10016-2507

Mailing address

71 Park Ave Ste 1C
New York, NY 10016-2507
Phone (267) 980-8704

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

LicenseStateTypeSpecialty
097702-1NYMDSocial Worker
088903NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1104360841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 PARK AVE STE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162507",
            "telephone_number": "267-980-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 PARK AVE STE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162507",
            "telephone_number": "267-980-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHENSON",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088903",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097702-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.