Mark Kim, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 13682 Issued in FL

Practice address

1600 W Eau Gallie Blvd
Suite 201U
Melbourne, FL 32935-4149

Phone

(626) 430-8472

NPI assigned

Oct 19, 2010

Sex

Male

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

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1649580002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 FICUS POINT DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401530",
            "telephone_number": "626-430-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD",
            "address_2": "SUITE 201U",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354149",
            "telephone_number": "626-430-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARK",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "7246634",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 13682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenzie Ireland Fearon Kilgore, BSN, RN
• Kristin Leigh Killebrew, PTA
• Katelyn E Kilpatrick
• Taylor Kilpatrick
• King Kim, D.M.D.
• Murray A Kimmel, D.O.
• Kimmelcare Family Practice PA
• Marcia Jean Kindler, P.T.
• Kindred Development 17, LLC
• Kindred Development 17, LLC

• All providers in Melbourne, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.