Kimberly Diaz-Rosso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101869 Issued in NY

Practice address

33 Fairview Ave
Port Washington, NY 11050-4015

Phone

(917) 435-8317

NPI assigned

Sep 13, 2022

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": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1992427306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 FAIRVIEW AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504015",
            "telephone_number": "917-435-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 FAIRVIEW AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504015",
            "telephone_number": "917-435-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-ROSSO",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101869",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Detor Jr., LCSW
• Gail Anne Deutsch, MSW LCSW
• Diagnostic & Imaging Associates
• Carrie E. Diamond, LMHC
• Krista Diaso, LCSW-R
• Astrida Inara Dikmanis, SLP
• Lynne Dinner, LCSW
• Robert Diraimo, M.D
• Daniil Diulger, DPT
• Doctors Pharmacy

• Clinical Social Worker in Port Washington, NY
• Providers in Port Washington, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.