Kimberly Rose Balducci, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P75124 Issued in NY

Practice address

250 W Main St
Bay Shore, NY 11706-8337

Phone

(631) 666-1951

NPI assigned

May 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Butterfly Clinical

  • Community/Behavioral Health Agency
  • Bayshore, NY
  • NPI 1932265683
  NPD (past)
• Butterfly Clinical Inc.

  • Clinical Social Worker
  • Bay Shore, NY
  • NPI 1184858441
  NPD (past)

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1306164298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068337",
            "telephone_number": "631-666-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068337",
            "telephone_number": "631-666-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDUCCI",
        "first_name": "KIMBERLY",
        "middle_name": "ROSE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P75124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Nicole Bailey, LPN
• Shernetta Marva Bailey, RN
• Dewan Chand Bajaj, LMSW
• Tanveer Akhtar Bajwa, M. D.
• Taibat Bakare
• Nicole V Balladares, PA
• Manju Kaur Balu, PHARMD
• Marie Josette Balzora X
• Alexandria Bamonte, CCC-SLP, TSSLD
• Danielle Banducci

• Mental Health Counselor in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.