Individual provider · Type 1 NPI
Mike Kim, PSY.D.
Prescribing (Medical) Psychologist · Albuquerque, NM
Practice location
2900 Louisiana Boulevard Northeast, Suite C1
Albuquerque, NM 87110
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prescribing (Medical) Psychologist Primary | 103TP0016X | 0036 (NM) |
| Psychologist | 103T00000X | PSY21256 (CA) |
Prescribing (Medical) Psychologist: 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has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or…
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About NPI 1104160910
Mike Kim, PSY.D.'s National Provider Identifier is 1104160910, issued on Nov 16, 2012. The primary taxonomy on file is Prescribing (Medical) Psychologist (103TP0016X), and the practice location is in Albuquerque, NM. The record was last updated on Sep 14, 2016.