DR. CHARLENE SUN KIM (NPI# 1356988539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356988539 |
| Entity Type | Individual |
| Full Name | DR. CHARLENE SUN KIM |
| Credential | PHD |
| Practice Address |
650 E Indian School Rd Phoenix AZ 85012-1839 |
| Practice Telephone | 6022775551 |
| Mailing Telephone | 6022775551 |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2020-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY-005095 | AZ | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY-005095 | AZ | Behavioral Health & Social Service Providers |
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
PSY-005095 | AZ | Behavioral Health & Social Service Providers |
| N | 103TH0004X |
Psychologist Specialization: Health |
PSY-005095 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
650 E INDIAN SCHOOL RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679579213 | Carlos J Carrera | Psychiatry & Neurology | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2005-06-27 |
| 1568063220 | Lucas Alan Bodine | Physical Therapist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-07 |
| 1417558206 | Elijah Robles Lazo | Physical Medicine & Rehabilitation | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-06 |
| 1871191486 | Samantha Roberts | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-10-15 |
| 1760099667 | Dino Alihodzic | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-25 |
| 1659986768 | Jennica Lynne Failner | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-15 |
| 1568074557 | Danielle Marie Mcgraw | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-20 |
| 1841802055 | Courtney Loera | Pharmacist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-19 |
| 1659980613 | Nakia Andrea Willis | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
| 1487263430 | Lauren Larue Waznik | Dietitian, Registered | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1407319486 | Joan Ledvina Parr | Psychologist | 13 Glenbrook Dr, Phoenix, MD 21131-2007 | 2019-04-08 |
| 1720591365 | Think Psychological and Consulting Services Pllc | Psychologist | 2632 S 83rd Ave Ste 100-481, Phoenix, AZ 85043-7206 | 2017-11-06 |
| 1558880682 | Christine Breuer | Psychologist | 21630 N 19th Ave Ste B17, Phoenix, AZ 85027-2715 | 2017-09-09 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1225584030 | Sojourner Health | Psychologist | 2224 E Fillmore St, Phoenix, AZ 85006-3815 | 2016-08-31 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1982097614 | T. M. Barratt | Psychologist | 3550 N. Central Ave. Suite 1407, Phoenix, AZ 85012 | 2015-03-04 |
| 1003204827 | Melissa Ann Lake | Psychologist | 4552 W Cottontail Rd, Phoenix, AZ 85086-1449 | 2014-12-31 |
| 1699196915 | Deborah Gladding | Psychologist | 36625 N 18th St, Phoenix, AZ 85086-5715 | 2014-01-05 |
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| 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.