Provider Demographics
NPI:1912145434
Name:GROCHER, KIMBERLY LAUREN BONDS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LAUREN BONDS
Last Name:GROCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:LAUREN
Other - Last Name:BONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:429 E PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1124
Mailing Address - Country:US
Mailing Address - Phone:301-529-9425
Mailing Address - Fax:
Practice Address - Street 1:280 DOBBS FERRY RD STE 102
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1908
Practice Address - Country:US
Practice Address - Phone:646-760-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078644104100000X
NY0794751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker