Individual provider Active NPI

Kim Marsala Cullen, LCSW-R

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1295163988
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040893-1 Issued in NY
Practice address
3215 Netherland Ave Apt 4C
Bronx, NY 10463-3421
Phone
(917) 648-6458
Fax
(718) 543-3073
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R040893-1 NY Primary

Addresses

Primary practice location

3215 Netherland Ave Apt 4C
Bronx, NY 10463-3421

Mailing address

3215 Netherland Ave Apt 4C
Bronx, NY 10463-3421
Phone (917) 623-3546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725001204 NY Practitioner - Clinical Social Worker 7719103779 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040893-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Apr 1, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Apr 1, 2021 Accepting new patients
Mental Health Providers of Western Queens, Inc. CurrentSince Jun 7, 2016 Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

7409 37th Ave
Ste 315
Jackson Heights, NY 11372
Phone (718) 672-1705

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

4404 Queens Blvd
Sunnyside, NY 11104
Phone (718) 706-1662

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1295163988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 NETHERLAND AVE APT 4C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633421",
            "telephone_number": "917-623-3546",
            "fax_number": "718-543-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 NETHERLAND AVE APT 4C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104633421",
            "telephone_number": "917-648-6458",
            "fax_number": "718-543-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSALA CULLEN",
        "first_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040893-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.