Individual ProviderKimberly DiazrossoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address33 Fairview Ave, Port Washington, NY 11050-4015(917) 435-8317PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Diazrosso does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1992427306Provider TypeIndividualFull NameDiazrosso, KimberlyCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date9/13/2022Last Updated12/29/2025Contact InformationPractice LocationPractice Address33 Fairview Ave, Port Washington, NY 11050-4015Phone(917) 435-8317FaxUnlisted FaxMailing LocationMailing Address33 Fairview Ave, Port Washington, NY 11050-4015Phone(917) 435-8317FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense101869New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense087292New York