Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kimberly Antoinette Bullock, LCSW

Individual provider Clinical Social Worker · NPI 1265708564

MS. Kimberly Antoinette Bullock, LCSW is a Clinical Social Worker in Jamaica, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

17657 132nd Ave
Jamaica, NY 11434-5839
Phone: (718) 712-1790
Fax: (516) 292-7008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 075392 (NY)

Record details

NPI number1265708564
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 30, 2012
Last updated in NPPESMarch 30, 2012

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