MR. KIM I MACK (NPI# 1699896795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699896795 |
| Entity Type | Individual |
| Full Name | MR. KIM I MACK |
| Credential | MFT |
| Practice Address |
712 Kern St Richmond CA 94805-1547 |
| Practice Telephone | 5102159665 |
| Mailing Telephone | 5102159665 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC 22328 | CA | Behavioral Health & Social Service Providers |
| Street Address |
712 KERN ST |
| City | RICHMOND |
| State | CA |
| Zip Code | 94805-1547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134622038 | Edward Trujano | Behavioral Analyst | 616 40th St, Richmond, CA 94805 | 2018-03-16 |
| 1568900439 | John Edward Tysell Jr. | Internal Medicine | 437 Carlston Street, Richmond, CA 94805 | 2017-02-10 |
| 1043661952 | Alejandra Cardenas | Counselor | 4101 Macdonald Avenue, Richmond, CA 94805 | 2016-06-22 |
| 1568582229 | Susan Denny | Marriage & Family Therapist | 207 37th Street, Richmond, CA 94805 | 2007-03-29 |
| 1548312689 | Wendy E Maron | Marriage & Family Therapist | 630 Humboldt St, Richmond, CA 94805 | 2007-01-17 |
| 1518015866 | Community Health for Asian Americans | Community/Behavioral Health | 207 37th St, Richmond, CA 94805 | 2007-01-05 |
| 1215496799 | Makenna Newton | Counselor | 303 41st St, Richmond, CA 94805 | 2019-03-14 |
| 1508399189 | Alejandra Olguin | Social Worker | 205 39th St, Richmond, CA 94805 | 2017-04-10 |
| 1760872451 | Deyda Mendoza | Counselor | 205 39th St, Richmond, CA 94805 | 2015-02-02 |
| 1245664036 | Leonard Deguzman | Counselor | 207 37th St, Richmond, CA 94805 | 2013-08-28 |
| Find all providers in zip 94805 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972120863 | Hugo Gonzales Therapy, Inc | Marriage & Family Therapist | 3150 Hilltop Mall Rd Ste 4, Richmond, CA 94806-1921 | 2020-06-26 |
| 1831734722 | Sudie Summers Althisar | Marriage & Family Therapist | 2000 Bremo Rd Ste 105, Richmond, VA 23226-2440 | 2019-11-14 |
| 1841841574 | Natalya Kuzmicheva | Marriage & Family Therapist | 2559 Groveview Dr, Richmond, CA 94806-5701 | 2019-09-24 |
| 1902308695 | Sheena R Horsford | Marriage & Family Therapist | 5516 Falmouth St Ste 201, Richmond, VA 23230-1819 | 2018-03-08 |
| 1659873818 | Yvette Coronado Mercer | Marriage & Family Therapist | 3700 Garden Rd, Richmond, VA 23235-1234 | 2018-03-05 |
| 1215311659 | Isaac Meadow | Marriage & Family Therapist | 6285 Bernhard Ave, Richmond, CA 94805-1633 | 2015-07-15 |
| 1164810487 | Geraldine Wilson | Marriage & Family Therapist | 4709 Macdonald Ave, Richmond, CA 94805-2308 | 2015-01-08 |
| 1568865855 | Shardae Washington | Marriage & Family Therapist | 211 N 18th St, Richmond, VA 23223-6905 | 2014-10-01 |
| 1194138230 | Mark Fischer | Marriage & Family Therapist | 627 Lenox Rd, Richmond, MA 01254-5260 | 2014-06-06 |
| 1801207444 | Tiana Beard | Marriage & Family Therapist | 3150 Hilltop Mall Rd Ste 12, Richmond, CA 94806-1921 | 2014-05-16 |
| Find all providers in RICHMOND | ||||
Please comment or provide details below to improve the information on MR. KIM I MACK.
| 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.