Active NPI
Mi Hae Kim, PSY.D.
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1780183731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS018279
- Practice address
- 2501B Reed St
Philadelphia, PA 19146-3900 - Phone
- (215) 568-2435
- NPI assigned
- Feb 5, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | PA | ||
| Clinical Psychologist | 103TC0700X | PS018279 | PA | Primary |
Addresses
Primary practice location
2501B Reed St
Philadelphia, PA 19146-3900
Mailing address
743 S 4TH St # 3F
Philadelphia, PA 19147-3125
Phone (562) 714-5857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS018279 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1780183731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "743 S 4TH ST # 3F",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191473125",
"telephone_number": "562-714-5857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501B REED ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191463900",
"telephone_number": "215-568-2435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MI HAE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-05",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "PA",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS018279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.