KIMBERLY H FORTIN (NPI# 1215046123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215046123 |
| Entity Type | Individual |
| Full Name | KIMBERLY H FORTIN |
| Credential | LCSW-R |
| Practice Address |
2693 East Brutus Street Weedsport NY 13166 |
| Mailing Address |
P.o. Box 1241 Weedsport NY 13166 |
| Practice Telephone | 3158342014 |
| Mailing Telephone | 3158342014 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
076593 | NY | Behavioral Health & Social Service Providers |
| Street Address |
2693 EAST BRUTUS STREET |
| City | WEEDSPORT |
| State | NY |
| Zip Code | 13166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053673467 | Amanda Jo Moffitt | Licensed Practical Nurse | 3619 Chamberlin Rd., Weedsport, NY 13166 | 2012-06-12 |
| 1275717415 | Michelle Maginn | Pharmacist | 2783 Nys Route 31, Weedsport, NY 13166 | 2007-12-24 |
| 1952599920 | Patricia Ann Jones | Registered Nurse | 2802 Sharon St, Weedsport, NY 13166 | 2007-10-04 |
| 1538276712 | Kph Healthcare Services, Inc. | Pharmacy | 2783 Nys Rt 31, Weedsport, NY 13166 | 2006-08-24 |
| 1760499495 | Melanie J Raymond | Physical Therapist | 2685 Erie Dr, Raymond Physical Therapy Pllc, Weedsport, NY 13166 | 2006-08-02 |
| 1821310681 | Jeremy M Carr | Pharmacist | 2783 Nys Route 31, Weedsport, NY 13166 | 2010-02-22 |
| 1548816564 | Sierra Jaeger | Student in an Organized Health Care Education/Training Program | 3 Cedar Ln, Weedsport, NY 13166-3119 | 2019-08-15 |
| 1568634129 | April M Russell | Licensed Practical Nurse | 30 Woodside Ln, Weedsport, NY 13166-3147 | 2008-03-24 |
| 1548318967 | Christine Roth Gutelius | Dietitian, Registered | 2523 State Route 31, Weedsport, NY 13166-3202 | 2007-01-08 |
| 1922150846 | Sean P. Boyle | Family Medicine | 2523 State Route 31, Weedsport, NY 13166-3202 | 2007-01-18 |
| Find all providers in zip 13166 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952129 | Elizabeth E Pascuzzi | Social Worker | 17 Copiague Pl, Copiague, NY 11726-3301 | 2020-11-08 |
| 1649871781 | Samantha Rizzo-bohsali | Social Worker | 20 Clermont Pl, Staten Island, NY 10314-4020 | 2020-11-05 |
| 1194326470 | Qwest Therapy Lcsw Pllc | Social Worker | 61 Fassitt Dr, Mahopac, NY 10541-3803 | 2020-11-04 |
| 1801497060 | Mary Beth Davis-steyer | Social Worker | 14 Cottonwood Cir, Saugerties, NY 12477-9300 | 2020-11-04 |
| 1538760905 | Herby Simonis | Social Worker | 10925 200th St, Saint Albans, NY 11412-1223 | 2020-11-03 |
| 1548861982 | Carl Joy Adelman | Social Worker | 15 Cisney Avenue, Floral Park, NY 11001-3249 | 2020-11-03 |
| 1831790195 | Emily Phyllis Wood | Social Worker | 6 Automation Ln Ste 112/113, Albany, NY 12205-1668 | 2020-11-03 |
| 1417558065 | Elizabeth Fagan | Social Worker | 108 E 91st St Apt 4c, New York, NY 10128-1659 | 2020-11-02 |
| 1255932885 | Kim Marie Yancey | Social Worker | 145 E 126th St Apt 3f, New York, NY 10035-1727 | 2020-11-02 |
| 1427659945 | Katherine Rechnio | Social Worker | 39 Horizon Farms Dr # 1, Warwick, NY 10990-2261 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.