Individual ProviderKimberly WallachSocial WorkerBehavioral Health & Social Service ProvidersPractice Address11 W Prospect Ave Fl 4, Mount Vernon, NY 10550-2017(914) 668-8938(914) 761-0600PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Wallach 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 3 days ago.Profile DetailsProvider ID1407528029Provider TypeIndividualFull NameWallach, KimberlyTitleMs.CredentialSTUDENT/INTERNGenderFemaleSole ProprietorNoEnumeration Date10/1/2021Last Updated2/1/2023Contact InformationPractice LocationPractice Address11 W Prospect Ave Fl 4, Mount Vernon, NY 10550-2017Phone(914) 668-8938Fax(914) 668-2545Mailing LocationMailing Address845 N Broadway, White Plains, NY 10603-2403Phone(914) 761-0600Fax(914) 761-5367Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense116885-01New YorkCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer