Kim Knox Faulkner, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

223 Issued in WY

Practice address

135 Pine Street
Suite B
Buffalo, WY 82834-2332

Phone

(307) 684-5828

Fax

(307) 684-5803

NPI assigned

Nov 2, 2005

Last updated

Jan 29, 2017By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Abintra Psychological Associates, LLC

  • Clinical Psychologist
  • Buffalo, WY
  • NPI 1710122908
  NPD (past)
• Rehabilitation Enterprises of Northeastern Wyoming

  • Clinical Psychologist
  • Sheridan, WY
  • NPI 1689716227
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485648000000",
    "number": "1215928965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PINE ST",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342332",
            "telephone_number": "307-684-5828",
            "fax_number": "307-684-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PINE STREET",
            "address_2": "SUITE B",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342332",
            "telephone_number": "307-684-5828",
            "fax_number": "307-684-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "KIM",
        "middle_name": "KNOX",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WY",
            "license": "223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119212400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherika Eve Erlenbusch
• Madonna Bell Esponda, L.P.C.
• Eye Attire LLC
• Family Medical Center
• Alaina Elise Fauber, PTA
• Theresa Anne Faulkner, PH.D.
• Ashley Lynn Ferguson
• First Empowerment Wraparound LLC
• Rhiannon Fowler, BA
• Joelle Paris France Lewis, LCSW

• Counseling Psychologist in Buffalo, WY
• Providers in Buffalo, WY by specialty
• Counseling Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2017; 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.