| Kim Psychiatric Services | |
|
200 Cordwainer Dr # 304 Norwell MA 02061-1671 | |
| (781) 546-2968 | |
| Not Available |
| Full Name | Kim Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 200 Cordwainer Dr # 304, Norwell, Massachusetts |
| Authorized Official Name and Position | Aisha King (PRACTICE MANAGER) |
| Authorized Official Contact | 8575260487 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Psychiatric Services 200 Cordwainer Dr # 304 Norwell MA 02061-1671 Ph: (781) 546-2968 | Kim Psychiatric Services 200 Cordwainer Dr # 304 Norwell MA 02061-1671 Ph: (781) 546-2968 |
| NPI Number | 1336793066 |
|---|---|
| Provider Enumeration Date | 07/31/2019 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Medicare PECOS PAC ID | 2466801543 |
|---|---|
| Medicare Enrollment ID | O20231214002142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336793066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jessica J Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487053328 PECOS PAC ID: 0446568786 Enrollment ID: I20151006001282 |
| Provider Name | Max Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760030787 PECOS PAC ID: 5496199218 Enrollment ID: I20240221000161 |
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