Active NPI
Michelle Kim
- Counselor
- Philadelphia, PA
National Provider Identifier
1972267474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PC013839
- Practice address
- 1740 South St Ste 403
Philadelphia, PA 19146-1514 - Phone
- (215) 990-4390
- NPI assigned
- Oct 29, 2021
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | PC013839 | PA | Primary |
Addresses
Primary practice location
1740 South St Ste 403
Philadelphia, PA 19146-1514
Mailing address
5031 Cedar Ave
Philadelphia, PA 19143-1620
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 |
|---|---|---|---|
| PC013839 | PA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1972267474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5031 CEDAR AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191431620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 SOUTH ST STE 403",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191461514",
"telephone_number": "215-990-4390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-29",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "PC013839",
"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 Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.