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

Individual provider Clinical Social Worker · NPI 1952540858

MS. Kristen Elizabeth Petullo, LCSW is a Clinical Social Worker in Nutley, New Jersey. Qualified in 2005, 21 years ago. Practices with Nutley Family Service Bureau, Inc, a 5-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
21
Licensed in
NJ
In the registry since
2009
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

169 Chestnut St
Nutley, NJ 07110-2311
Phone: (973) 951-2326
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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 44SC05335000 (NJ)

Record details

NPI number1952540858
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedFebruary 17, 2009
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Nutley Family Service Bureau, Inc. — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Nutley