Provider / Organization | NPI | Date Certified |
---|---|---|
SOYEONG KIM | 1447877675 | 2020-07-03 |
Soyeong Kim is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1447877675. Registration indicates Soyeong Kim is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Psychologist (Behavioral Health & Social Service Providers, Psychologist) (Psychologist: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Psychologist Clinical, Behavioral Health & Social Service Providers) (Psychologist, )
Registration | PART-B:Y DME:Y HHA:N PMD:N |
Entity Type | Individual |
Provider Name | Soyeong Kim PHD |
Practice Office Address | 55 FRUIT ST BOSTON, MA US |
Practice Office Telephone | 6177245202 |
Mailing Address | 1 CONSTITUTION PLZ CHARLESTOWN, MA 021292025 US |
Business Telephone | 8572623160 |
Address | City / State | Phone / Fax |
---|---|---|
400 Massasoit Ave Ste 305 | East Providence, RI 029142012 | 4014314552 42 |
Code | Practice | License No State |
---|---|---|
103TC0700X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Psychologist Behavioral Health & Social Service Providers Psychologist Psychologist: Clinical Behavioral Health/Substance Abuse/Psychiatry Psychologist Clinical Behavioral Health & Social Service Providers Psychologist | PS01852
RI |