| Namu Integrative Therapy Services, Llc | |
|
1145 Grand Ave # 101 Saint Paul MN 55105-2629 | |
| (612) 594-6910 | |
| Not Available |
| Full Name | Namu Integrative Therapy Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1145 Grand Ave # 101, Saint Paul, Minnesota |
| Authorized Official Name and Position | Hye-kyong Kim (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6124240051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Namu Integrative Therapy Services, Llc 1145 Grand Ave # 101 Saint Paul MN 55105-2629 Ph: (612) 424-0051 | Namu Integrative Therapy Services, Llc 1145 Grand Ave # 101 Saint Paul MN 55105-2629 Ph: (612) 594-6910 |
| NPI Number | 1275175242 |
|---|---|
| Provider Enumeration Date | 10/11/2019 |
| Last Update Date | 05/25/2023 |
| Certification Date | 05/25/2023 |
| Medicare PECOS PAC ID | 3870957483 |
|---|---|
| Medicare Enrollment ID | O20230915000701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275175242 | NPI | - | NPPES |
| 1962759217 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Hye-kyong Kim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962759217 PECOS PAC ID: 1850541921 Enrollment ID: I20121025000709 |
| Provider Name | Caitlyn A Nguyen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023615028 PECOS PAC ID: 8820435092 Enrollment ID: I20240322003411 |
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