IndividualActive
Mike Kim, PSY.D.
NPI 1104160910 · Prescribing (Medical) Psychologist · Albuquerque, NM
Provider details
- NPI number
- 1104160910
- Entity type
- Individual
- Primary specialty
- Prescribing (Medical) PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0036 (NM)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
2900 Louisiana Boulevard Northeast
Suite C1
Albuquerque, NM 87110
Phone: (505) 884-7873
Approximate (ZIP-level) locationGet directions
Mailing address
2900 Louisiana Boulevard Northeast
Albuquerque, NM 87110
Registry dates
- Enumerated
- 2012-11-16
- Last updated
- 2016-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.