Melissa Jean King, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6535 Issued in MN

Practice address

205 W 2ND St Ste 437
Duluth, MN 55802-1922

Phone

(218) 722-2005

NPI assigned

May 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Duluth Psychological Clinic IncGroup PAC ID 5395835243, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Duluth Psychological Clinic Inc

  • Clinical Psychologist
  • Duluth, MN
  • NPI 1730243809
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1871115337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N MANHATTAN AVE APT 11",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665025370",
            "telephone_number": "525-991-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 437",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021922",
            "telephone_number": "218-722-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MELISSA",
        "middle_name": "JEAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "6535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Jae Kim, LICSW
• David Lee Kimmer
• Gary Charles Kindt
• Deborah Ann King
• Jack King
• Timothy Allen King, M.D.
• Katti Renee Kinnear, APRN CNP
• Elizabeth R Kinney, LICSW
• Sydney Cailyn Yingling Kinney, PA-C
• Eric Kirchner, M.D.

• Counseling Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.