NPIMap

Organization Active NPI

Namu Integrative Therapy Services, LLC

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1275175242
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
NAMU INTEGRATIVE THERAPY SERVICES, LLC
Practice address
1145 Grand Ave # 101
Saint Paul, MN 55105-2629
Phone
(612) 594-6910
NPI assigned
Oct 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Hye-Kyong Kim, PSYD, LP, SEPNPI 1962759217
Title
Psychologist/Owner
Phone
(612) 424-0051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1145 Grand Ave # 101
Saint Paul, MN 55105-2629

Mailing address

1145 Grand Ave # 101
Saint Paul, MN 55105-2629
Phone (612) 424-0051

Other identifiers 1

IdentifierTypeStateIssuer
1962759217MedicaidMN

Other names 2

  • Namu Integrative Therapy Services, LLC Doing business as
  • Hye-Kyong Kim Therapy LLC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Hye-Kyong@namuintegrative.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230915000701 MN Part B Supplier - Clinic/Group Practice 3870957483 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: hye-kyong@namuintegrative.com

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": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1275175242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 GRAND AVE # 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "612-424-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 GRAND AVE # 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "612-594-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAMU INTEGRATIVE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYE-KYONG",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "612-424-0051",
        "authorized_official_credential": "PSYD, LP, SEP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962759217",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hye-Kyong@namuintegrative.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1145 Grand Ave # 101",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551052629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Namu Integrative Therapy Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Namu Integrative Therapy Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hye-Kyong Kim Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.

Verify at the official NPI Registry.