Abigail J Kimm, PHD, LP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PSY.0005888 Issued in CO

Practice address

3021 Upland Dr Unit 6
Fort Collins, CO 80526-5871

Phone

(970) 658-9182

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Aj Kimm Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1356065312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 UPLAND DR UNIT 6",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265871",
            "telephone_number": "970-658-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 UPLAND DR UNIT 6",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265871",
            "telephone_number": "970-658-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMM",
        "first_name": "ABIGAIL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "PSY.0005888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AJ",
            "last_name": "KIMM",
            "prefix": "DR.",
            "credential": "LP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Counseling Psychologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Counseling Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.