Active NPI
Katherine Rhodes Kim
- Mental Health Counselor
- Cumming, GA
National Provider Identifier
1730804527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 008637
- Practice address
- 314 Tribble Gap Rd
Cumming, GA 30040-2475 - Phone
- (770) 742-7479
- NPI assigned
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 008637 | GA | Primary |
Addresses
Primary practice location
314 Tribble Gap Rd
Cumming, GA 30040-2475
Mailing address
314 Tribble Gap Rd
Cumming, GA 30040-2475
Phone (770) 742-7479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 9, 2024 through Dec 9, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Path to Change, LLC | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1730804527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 TRIBBLE GAP RD",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402475",
"telephone_number": "770-742-7479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 TRIBBLE GAP RD",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402475",
"telephone_number": "770-742-7479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KATHERINE",
"middle_name": "RHODES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "008637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.