Kristin Ann Di Vico, LMSW, MSPT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

126167-01 Issued in NY

Practice address

275 North St
Harrison, NY 10528-1140

Phone

(914) 967-6500

NPI assigned

Jul 25, 2007

Last updated

Feb 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1700076866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N SHELLEY ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471441",
            "telephone_number": "914-588-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NORTH ST",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281140",
            "telephone_number": "914-967-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 N Shelley St",
            "address_purpose": "LOCATION",
            "city": "Mohegan Lake",
            "state": "NY",
            "postal_code": "105471441",
            "country_code": "US",
            "telephone_number": "914-588-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DI VICO",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "credential": "LMSW, MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "126167-01",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "PT-014318-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeanne C. Dietrich
• James Dimartino
• Jodian Dinall

• Social Worker in Harrison, NY
• Providers in Harrison, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.