DR. MIKE KIM


Address: 2900 Louisiana Boulevard Northeast, Suite C1, Albuquerque, NM 87110
Phone: 5058847873

DR. MIKE KIM (NPI# 1104160910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104160910
Entity Type Individual
Full Name DR. MIKE KIM
Credential PSY.D.
Practice Address 2900 Louisiana Boulevard Northeast
Suite C1
Albuquerque
NM 87110
Practice Telephone 5058847873
Mailing Telephone 5058847873
Enumeration Date 2012-11-16
Last Update Date 2016-09-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist PSY21256 CA Behavioral Health & Social Service Providers
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
0036 NM Behavioral Health & Social Service Providers

Other Providers MIKE KIM

NPI Name Taxonomy Address Enumeration
1568022242 Mike Sunwoo Kim Student in an Organized Health Care Education/Training Program 301 Fisher St Rm 1g123, Keesler Afb, MS 39534-2519 2019-06-16
1134396112 Mike Tae Seok Kim Family Medicine 840 W Irving Park Rd, Ste 201, Chicago, IL 60613-3011 2008-05-09
1184818973 Mike Y Kim Dentist 14820 Pacific Ave S, Tacoma, WA 98444-4655 2007-09-05
1386764934 Mike S. Kim Pharmacist 25965 Normandie Ave, Harbor City, CA 90710-3416 2007-03-29
1215968706 Mike Kim Chiropractor 3511 W Olympic Blvd, 202, Los Angeles, CA 90019-3563 2006-07-05

Office Location

Street Address 2900 LOUISIANA BOULEVARD NORTHEAST
SUITE C1
City ALBUQUERQUE
State NM
Zip Code 87110

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932533361 Abq Psychiatric Services, LLC Community/Behavioral Health 2900 Louisiana Boulevard Northeast, Suite C1, Albuquerque, NM 87110 2013-08-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215550199 Sabrina Jennifer Lujan Counselor 8401 Constitution Ave Nw, Albuquerque, NM 87110 2020-05-26
1649829318 Robert D. Oliver Technician 2705 Texas Street Ne, Albuquerque, NM 87110 2019-09-05
1033770904 Life Re-created LLC Counselor 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 2019-06-21
1497319693 Clear Choice Vision Care, LLC Optometrist 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 2019-04-24
1790257558 Diana M Nicolas Dietitian, Registered 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 2018-12-18
1689168403 Robin N Hermes, Md, PC Anesthesiology 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 2018-06-15
1710481726 Desert Mountain Eyecare LLC Optometrist 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 2018-03-23
1659873131 Amanda Lacasse Registered Nurse 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 2018-03-01
1518485655 Danielle Liegh Wyne Counselor 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 2017-09-08
1265957237 Myrrhine Faller Speech-Language Pathologist 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 2017-08-10
Find all providers in zip 87110

Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003218553 Integrated Healthcare of New Mexico Psychologist 7632 William Moyers Ave Ne, Albuquerque, NM 87122-2765 2014-09-16
1245856913 Paul King-miller Psyd Lpcc LLC Psychologist 11216 Brentwood Hills Blvd Ne, Albuquerque, NM 87112-3219 2020-06-18
1477585990 Deborah Leslie Kos Psychologist 4810 Hardware Dr Ne, Albuquerque, NM 87109-2013 2006-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417489378 Primary Wellness Team Corporation Psychologist 5805 Mcnutt Rd, Ste D, Santa Teresa, NM 88008-8001 2017-03-30
1154877371 J. Michael Mash Prescribing Psychologist LLC Psychologist 4155 State Road 68, Unit 6, Rancho De Taos, NM 87557 2016-08-28
1124466446 Shekinah Foundation Psychologist 3001 S Wyoming Ave, Roswell, NM 88203-2326 2013-06-08
1902197098 S M Cobb Psychologist 400 N Pennsylvania Ave Ste 990, Roswell, NM 88201-4754 2011-04-25
1730203860 Pattijo N Velasquez Psychologist 1505 S Don Roser Dr, Ste. A, Las Cruces, NM 88011-4596 2007-03-16
1285232397 Dr Tony J Kreuch LLC Psychologist 2204 Brothers Rd Ste B, Santa Fe, NM 87505-6975 2020-10-12
1548677669 Winds of Change Mental Health Services, LLC Psychologist 108 E High St, Grants, NM 87020-2453 2014-07-21
1982024105 Drw Behavioral Health Services, LLC Psychologist 1395 Missouri Ave, Las Cruces, NM 88001-5327 2014-04-27

Competitor

Search similar providers

City ALBUQUERQUE
Zip Code 87110

Improve Information

Please comment or provide details below to improve the information on DR. MIKE KIM.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches