Kimberly Ruth Addesso, LMSW
Individual provider Active NPI Social Worker · Kingston, NY
NPI 1386828952 · NPPES record last updated Dec 19, 2007
Key facts
- NPI
- 1386828952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 0578111 (NY)
- Practice address
- 131 Rymrock Rd Unit 49
Kingston, NY 12401-7458 - Phone
- (845) 532-4994
- Fax
- (845) 334-4972
- NPI assigned
- Dec 19, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0578111 | NY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0578111 | NY | Yes |
Addresses
Primary practice location
131 Rymrock Rd Unit 49
Kingston, NY 12401-7458
Mailing address
131 Rymrock Rd Unit 49
Kingston, NY 12401-7458
Phone (845) 532-4994
Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2007. 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.