Active NPI
MKM Holdings, Inc
- Marriage & Family Therapist
- Portsmouth, NH
National Provider Identifier
1124706791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Legal business name
- MKM HOLDINGS, INC
- Practice address
- 501 Islington St Ste 2D
Portsmouth, NH 03801-5346 - Phone
- (760) 799-9719
- NPI assigned
- Jul 5, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Gass
- Title
- Owner
- Phone
- (760) 799-9719
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
501 Islington St Ste 2D
Portsmouth, NH 03801-5346
Mailing address
501 Islington St Ste 2D
Portsmouth, NH 03801-5346
Phone (760) 799-9719
Other names 1
- ELLIE MENTAL HEALTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, MA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240725002334 | NH | Part B Supplier - Clinic/Group Practice | 5698211613 |
Receives reassigned benefits from 4 practitioners Practice locations: Portsmouth, NH |
| O20251218001402 | MA | Part B Supplier - Clinic/Group Practice | 5698211613 |
Receives reassigned benefits from 2 practitioners Practice locations: Pittsfield, MA |
National Provider Directory
National Provider DirectoryLocations
501 Islington St
Portsmouth, NH 03801
501 Islington St
Ste 2D
Portsmouth, NH 03801
Phone (603) 288-1254
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1688515200000",
"number": "1124706791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 ISLINGTON ST STE 2D",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015346",
"telephone_number": "760-799-9719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 ISLINGTON ST STE 2D",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015346",
"telephone_number": "760-799-9719"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MKM HOLDINGS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-05",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A",
"authorized_official_last_name": "GASS",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "760-799-9719"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ELLIE MENTAL HEALTH",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Portsmouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.