Provider Demographics
NPI:1457055303
Name:TAKING CARE OF ME, LCSW, PLLC
Entity Type:Organization
Organization Name:TAKING CARE OF ME, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:914-257-3593
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-0356
Mailing Address - Country:US
Mailing Address - Phone:914-257-3593
Mailing Address - Fax:
Practice Address - Street 1:21 FORD CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4945
Practice Address - Country:US
Practice Address - Phone:315-885-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty