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MS. KIMBERLY ANTOINETTE BULLOCK LCSW
NPI 1265708564
Social Worker - Clinical in Jamaica, NY

Active since March 30, 2012
17657 132ND AVE, JAMAICA, NY 11434(718) 712-1790(516) 292-7008 Get Directions Write a Review

NPPES record last updated: March 30, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ms. Kimberly Antoinette Bullock Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIMBERLY ANTOINETTE BULLOCK LCSW (NPI 1265708564) is an individual clinical provider in Jamaica, New York, licensed in New York (075392) and active in the NPI registry since March 2012.

NPPES Registry Identity

NPI1265708564
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. KIMBERLY ANTOINETTE BULLOCKCredential: LCSW
Location Address17657 132ND AVEJamaica, NY 11434-5839
Mailing Address17657 132nd AveJamaica, NY 11434-5839 · (718) 712-1790 · Fax (516) 292-7008
Phone(718) 712-1790
Fax(516) 292-7008
Sole ProprietorYes
Enumeration DateMarch 30, 2012
✔ NPI 1265708564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 075392
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
17657 132ND AVE, Jamaica, NY 11434
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Bullock's NPI number?

The NPI number for Kimberly Bullock is 1265708564. It was assigned to this individual provider in the NPPES registry on March 30, 2012.

Where is Kimberly Bullock located?

Kimberly Bullock practices at 17657 132nd Ave, Jamaica, NY 11434. The listed phone number is (718) 712-1790.

What is Kimberly Bullock's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kimberly Bullock was last updated on March 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.