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NPI Code Detail

MEDICARE: KIMBERLY NICOLE SERVELLO LSW, LMSW

MEDICARE: KIMBERLY NICOLE SERVELLO LSW, LMSW
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
1104100000XSocial Worker131388-01NY
2104100000XSocial Worker44SL07386100NJ

General Provider Information

NPI Number : 1356279889
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NICOLE SERVELLO LSW, LMSW
Provider Business Mailing Address
First Line : 2 MARINE VIEW PLZ APT 6B
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 221 RIVER ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5989
Country : US
Telephone Number : 516-505-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “ KIMBERLY NICOLE SERVELLO LSW, LMSW” Practice Location

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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.

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