Active NPI
Sahra Kim, M.A., PSY.D.
- Psychologist
- Boston, MA
National Provider Identifier
1295242303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY33169
- Practice address
- 150 S Huntington Ave
Boston, MA 02130-4817 - Phone
- (323) 206-8374
- NPI assigned
- Jan 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY33169 | MA | Primary |
Addresses
Primary practice location
150 S Huntington Ave
Boston, MA 02130-4817
Mailing address
380 Harrison Ave Unit PH2F
Boston, MA 02118-3779
Phone (323) 206-8374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 17, 2024 through Jun 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY33169 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memory Gains PLLC | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Psychologist
- Boston, MA
- NPI 1881452688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1295242303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 HARRISON AVE UNIT PH2F",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183779",
"telephone_number": "323-206-8374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "323-206-8374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SAHRA",
"credential": "M.A., PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-10",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "PSY33169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.