MEDICARE: KIMBERLY JEAN NICHOLS LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R076662-1	NY

General Provider Information

NPI Number	:	1205237948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY JEAN NICHOLS LCSW-R

Provider Business Mailing Address
First Line	:	1902 ROSEWOOD CT
Second Line	:
City	:	HIGHLAND MILLS
State	:	NY
Zip	:	10930-5222
Country	:	US
Telephone Number	:	914-257-3593
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 N BROADWAY STE 101
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-2657
Country	:	US
Telephone Number	:	914-257-3593
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	01/23/2019

Similar Medicare Providers

1326047978 — DR. STEPHEN GERSTMAN D.D.S.
Practice Location Address:

245 N BROADWAY , SUITE 108
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-631-5217
Practice Fax: 914-332-4461

1033124821 — HUDSON NEUROLOGY AND NEUROPHYSIOLOGY PC
Practice Location Address:

245 N BROADWAY STE 102
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-631-6888
Practice Fax: 914-631-2700

1609290865 — ALYSSA PRETE
Practice Location Address:

245 N BROADWAY STE 207
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-806-7376
Practice Fax:

1942606702 — MS. CHRYSSA TSAKIRIS LAC
Practice Location Address:

245 N BROADWAY STE 207
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-418-5679
Practice Fax:

1316467269 — ROSSARIN MITSUMOTO D.D.S., P.C.
Practice Location Address:

245 N BROADWAY STE 108
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-332-1272
Practice Fax: 914-332-1261

1306361589 — MRS. KWANGHEE LYEW LAC.
Practice Location Address:

245 N BROADWAY STE 206
SLEEPY HOLLOW, NY
10591-2657

Practice Phone: 914-522-0536
Practice Fax:

Directions to “ KIMBERLY JEAN NICHOLS LCSW-R” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.