Young K Kim, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6044 Issued in MA

Practice address

155 Maple St
Ste 301
Springfield, MA 01105-1828

Phone

(413) 736-5393

Fax

(413) 736-5100

NPI assigned

Dec 6, 2006

Last updated

Mar 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Essential Diabetes and Primary Care Center, LLC

  • Primary Care Clinic/Center
  • Springfield, MA
  • NPI 1023885464
  NPD (past)
• Luz M. Martin, M.D. P.C.

  dba Luz M. Martin, M.D. & Associates

  • Counselor
  • Westfield, MA
  • NPI 1770570079
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1033278973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LAWRENCE DRIVE",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "01106",
            "telephone_number": "413-567-6724",
            "fax_number": "413-567-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MAPLE ST",
            "address_2": "STE 301",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051828",
            "telephone_number": "413-736-5393",
            "fax_number": "413-736-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS",
            "identifier": "W04819",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "000000020085",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0520772",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ji Won Kim
• Ji Yoon Kim, PHARMD
• Paul Kim, MD
• Tommy Kim, MD
• Young Hee Kim, MS, RD, CNSD
• Grace Miriam Kimball
• Ryan D Kindle, MD
• Kindred Healing Counseling Services, LLC
• Eunice B King Whitaker, BA
• Dawn King

• Clinical Psychologist in Springfield, MA
• Providers in Springfield, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.