Kim T Vo-Fernandez, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011764 Issued in NY

Practice address

636 Plank Rd
Clifton Park, NY 12065-2046

Phone

(518) 545-4691

NPI assigned

Mar 8, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1508566456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 VAN VORST DR",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279711",
            "telephone_number": "717-304-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 PLANK RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652046",
            "telephone_number": "518-545-4691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Van Vorst Dr",
            "address_purpose": "LOCATION",
            "city": "Burnt Hills",
            "state": "NY",
            "postal_code": "120279711",
            "country_code": "US",
            "telephone_number": "717-304-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VO-FERNANDEZ",
        "first_name": "KIM",
        "middle_name": "T",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.