Kimberly Lee Blackshear, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Pittsford, NY

NPI 1366397648 · NPPES record last updated Mar 2, 2026

Key facts

NPI
1366397648
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
098453 (NY)
Practice address
64 Crestview Dr
Pittsford, NY 14534-2241
Phone
(919) 816-5263
NPI assigned
Mar 2, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
098453NYMDSocial Worker
C016725NCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C016725 NC
Clinical Social Worker 1041C0700X 098453 NY Yes

Addresses

Primary practice location

64 Crestview Dr
Pittsford, NY 14534-2241

Mailing address

64 Crestview Dr
Pittsford, NY 14534-2241
Phone (919) 816-5263

Other providers in Pittsford, NY

All providers in Pittsford, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.