Healthcare Provider Details

I. General information

NPI: 1265378475
Provider Name (Legal Business Name): KIMBERLEY MATHIAS, LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 NORMANSKILL BLVD STE 201
DELMAR NY
12054-1331
US

IV. Provider business mailing address

2 NORMANSKILL BLVD STE 201
DELMAR NY
12054-1331
US

V. Phone/Fax

Practice location:
  • Phone: 518-859-8218
  • Fax:
Mailing address:
  • Phone: 518-859-8218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLEY MATHIAS
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 518-859-8218