Jennifer Allyn Yang Kyung Kim-Ardakani

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4369 Issued in MN

Practice address

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

Phone

(651) 280-2310

Fax

(651) 280-3995

NPI assigned

Jan 10, 2024

Last updated

Dec 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amherst H. Wilder Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1548337355
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1104697903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310",
            "fax_number": "651-280-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310",
            "fax_number": "651-280-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-ARDAKANI",
        "first_name": "JENNIFER",
        "middle_name": "ALLYN YANG KYUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus K Kilian, PSY.D.
• Yvonne Marie Kilkelly, LICSW, LMFT
• Dirk Killelea, PHARMD
• Kim Home Care
• Emma Kim Rust
• Alexis Kim, OTR/L
• Charles S. Kim, M.D.
• Hye-Kyong Kim, PSYD, LP
• Jong Duk Kim, M.D.
• Peter David Kim, MD

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.