Healthcare Provider Details

I. General information

NPI: 1245675966
Provider Name (Legal Business Name): KIMBERLY KLAPPERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 NORTH OCEAN AVE
PATCHOGUE NY
11772
US

IV. Provider business mailing address

8 BOWMAN LANE
KINGS PARK NY
11754
US

V. Phone/Fax

Practice location:
  • Phone: 631-207-1053
  • Fax:
Mailing address:
  • Phone: 631-827-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: