Active NPI
Kelly Su Lim, LMT, CLT
- Massage Therapist
- West Hartford, CT
National Provider Identifier
1932313863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 6200
- Practice address
- 65 Memorial Rd
Suite 410
West Hartford, CT 06107-2434 - Phone
- (860) 368-1648
- NPI assigned
- May 10, 2007
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 6200 | CT | Primary |
Addresses
Primary practice location
65 Memorial Rd
Suite 410
West Hartford, CT 06107-2434
Mailing address
PO Box 230861
Hartford, CT 06123-0861
Phone (860) 368-1648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1856 | Other | CO | STATE OF COLORADO MASSAGE THERAPY LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6200 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363996800000",
"number": "1932313863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 230861",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061230861",
"telephone_number": "860-368-1648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 MEMORIAL RD",
"address_2": "SUITE 410",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072434",
"telephone_number": "860-368-1648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "KELLY",
"middle_name": "SU",
"name_prefix": "Ms.",
"credential": "LMT, CLT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2013-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "6200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF COLORADO MASSAGE THERAPY LICENSE",
"identifier": "1856",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.