Kim Marie Baldwin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008516 Issued in IL

Practice address

207 W Jefferson St Ste 304
Bloomington, IL 61701-3969

Phone

(309) 204-6614

NPI assigned

Mar 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kim Baldwin Psychological Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
  • NPI 1629700422
  NPD Authorized official

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1295906576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W JEFFERSON ST STE 304",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013969",
            "telephone_number": "309-204-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W JEFFERSON ST STE 304",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013969",
            "telephone_number": "309-204-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000794",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylie Bakalar
• Chelsey Baker
• Nicholas Edward Baker, DMD
• Zoe Jane Baker, LCSW
• Prithvi Balaji
• Mi H Balgemann, DNP, CRNA
• Catherine L Ballard, RN
• Robert S Baller, MD
• Surya Lakshmi Rani Balusu, RPH
• Bethany Bane

• Clinical Psychologist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.