Individual provider Active NPI

Kimberly Bravo, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1861048951
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100114 Issued in NY
Practice address
1824 Madison Ave
New York, NY 10035-3832
Phone
(212) 423-4500
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111635 NY
Clinical Social Worker 1041C0700X 100114 NY Primary

Addresses

Primary practice location

1824 Madison Ave
New York, NY 10035-3832

Mailing address

830 Amsterdam Ave Apt 3F
New York, NY 10025-5128

Other practice location 1

1841 Park Ave
New York City, NY 10035-1316
Phone (646) 459-6174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812004599 NY Practitioner - Clinical Social Worker 2163920745 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111635NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health Clinical CurrentSince Jun 5, 2025 Accepting new patients
The Institute for Family Health Clinical Current Accepting new patients
The Institute for Family Health Clinical CurrentSince Jun 5, 2025 Accepting new patients

Locations

16 E 16th St
New York, NY 10003
Phone (212) 633-0800

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1861048951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 AMSTERDAM AVE APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York City",
            "state": "NY",
            "postal_code": "100351316",
            "country_code": "US",
            "telephone_number": "646-459-6174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "111635",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.