Christopher M. Kilcullen, LCSW R
Individual provider Active NPI Clinical Social Worker · Nyc, NY
NPI 1306100573 · NPPES record last updated Sep 6, 2012
Key facts
- NPI
- 1306100573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- R030210-1 (NY)
- Practice address
- 145-A East 94TH Street
Ground Level
Nyc, NY 10128 - Phone
- (718) 432-2783
- NPI assigned
- Jul 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R030210-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R030210-1 | NY | Yes |
Addresses
Primary practice location
145-A East 94TH Street
Ground Level
Nyc, NY 10128
Mailing address
145-A East 94TH St.
Ground Floor
New York, NY 10128
Phone (718) 432-2783
Other providers in Nyc, NY
- Sandra Infantino
- Arden Marc Kaisman
- Susan W Katz
- Samuel Kenan
- Shahzad Massimo Khan
- Douglas Hunt King
- Kathy Kouroupas
- Emily Laitmon
- Jiyon Lee
- Steven J Lee
All providers in Nyc, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.