Active NPI
Nicole Lynn Klim, LMSW
- Mental Health Counselor
- Southgate, MI
National Provider Identifier
1821250754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6801078437
- Practice address
- 19291 Northline Rd
Southgate, MI 48195-2220 - Phone
- (734) 287-1500
- Fax
- (734) 287-1660
- NPI assigned
- Jul 1, 2008
- 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 | 6801078437 | MI | Primary |
Addresses
Primary practice location
19291 Northline Rd
Southgate, MI 48195-2220
Mailing address
19291 Northline Rd
Southgate, MI 48195-2220
Phone (734) 287-1500
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Justin W Peer PLLC | Mental Health | 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": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1821250754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19291 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952220",
"telephone_number": "734-287-1500",
"fax_number": "734-287-1660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19291 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952220",
"telephone_number": "734-287-1500",
"fax_number": "734-287-1660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLIM",
"first_name": "NICOLE",
"middle_name": "LYNN",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6801078437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.