DR. MIKE KIM PSY.D. NPI 1104160910

NPI Information

  • NPI: 1104160910
  • Provider Name: DR. MIKE KIM, PSY.D.
  • Classification: Psychologist - 103TP0016X
  • Specialization: Prescribing (Medical)
  • Entity Type: Individual
  • Address: 2900 LOUISIANA BOULEVARD NORTHEAST
    SUITE C1
    ALBUQUERQUE, NM
    ZIP 87110
  • Phone: (505) 884-7873

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NPI Details

DR. Mike Kim, PSY.D. is a prescribing (medical) psychologist in Albuquerque, NM. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. DR. Mike Kim, PSY.D. NPI is 1104160910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2900 LOUISIANA BOULEVARD NORTHEAST
SUITE C1
ALBUQUERQUE, NM
ZIP 87110
Phone: (505) 884-7873

The enumeration date for this NPI number is 11/16/2012 and was last updated on 9/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologistPSY21256CALIFORNIANo
2103TP0016XPsychologistPrescribing (Medical)0036NEW MEXICOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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