Active NPI
Grace E Kim
- Mental Health Counselor
- Flushing, NY
National Provider Identifier
1083096283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P01879
- Practice address
- 14015 Sanford Ave
Flushing, NY 11355-2686 - Phone
- (718) 358-8288
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | P01879 | NY | Primary |
Addresses
Primary practice location
14015 Sanford Ave
Flushing, NY 11355-2686
Mailing address
14628 27TH Ave
1 FL
Flushing, NY 11354-1428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P01879 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1083096283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14628 27TH AVE",
"address_2": "1 FL",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113541428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14015 SANFORD AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552686",
"telephone_number": "718-358-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "GRACE",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P01879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.