Amy Ruth Kim, LPCC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1145 Issued in MN

Practice address

7438 Blaisdell Ave
Richfield, MN 55423-4136

Phone

(763) 250-8385

NPI assigned

Jul 24, 2012

Last updated

Feb 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1699021923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7438 BLAISDELL AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554234136",
            "telephone_number": "763-250-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7438 BLAISDELL AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554234136",
            "telephone_number": "763-250-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AMY",
        "middle_name": "RUTH",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1145",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elyse Kelly, M.S., CCC-SLP
• Jules J Kennedy
• Patrick Kennedy, LICSW
• Jessica Gale Kessler, NP
• Daniel Orlin Keys, MD
• Michael John King, PA-C
• Josie Kipp
• Westin Jaide Kirk
• Madeline Klaysmat, PA-C
• Michelle Kloke

• Community/Behavioral Health Agency in Richfield, MN
• Providers in Richfield, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.