Individual provider Active NPI

Robin Nicole Kim, MA MFT

  • Marriage & Family Therapist
  • Rochester, MI
National Provider Identifier
1205142882
Registry record updated Mar 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
71 Walnut Blvd Ste 109
Rochester, MI 48307-2073
Phone
(248) 657-7875
NPI assigned
Aug 20, 2010
Last updated
Mar 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X MI Primary

Addresses

Primary practice location

71 Walnut Blvd Ste 109
Rochester, MI 48307-2073

Mailing address

71 Walnut Blvd Ste 109
Rochester, MI 48307-2073
Phone (248) 657-7875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20250117000962 MI Practitioner - Marriage and Family Therapist 8123556214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

71 Walnut Blvd
Suite 109
Rochester, MI 48307-2073
Phone (248) 657-7875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Pathways, LLC Marriage & Family Therapist CurrentSince Nov 26, 2024 Accepting new patients

Locations

71 Walnut Blvd
Ste 109
Rochester, MI 48307
Phone (248) 505-6289

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710028800000",
    "number": "1205142882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 WALNUT BLVD STE 109",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072073",
            "telephone_number": "248-657-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WALNUT BLVD STE 109",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072073",
            "telephone_number": "248-657-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROBIN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MA MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2024-03-10",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.