Provider Demographics
NPI:1851265110
Name:BERNSTEIN, KIMBERLY (PHD, LP, NCPSYA)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PHD, LP, NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 85TH ST APT 6I
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372
Mailing Address - Country:US
Mailing Address - Phone:917-374-7304
Mailing Address - Fax:
Practice Address - Street 1:611 BROADWAY, SUITE 532
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012
Practice Address - Country:US
Practice Address - Phone:917-374-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000895102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst