Provider Demographics
NPI:1861146086
Name:VELASQUEZ, KIMBERLY DENNISE (MSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DENNISE
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BERGEN AVE APT 1201
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1783
Mailing Address - Country:US
Mailing Address - Phone:917-470-3945
Mailing Address - Fax:
Practice Address - Street 1:275 7TH AVE FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6756
Practice Address - Country:US
Practice Address - Phone:212-604-1774
Practice Address - Fax:646-537-1438
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker