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General NPI Number Information
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NPI Number | 1447124243
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Entity Type | Organization
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Legal Business Name | TESS KIM THERAPEUTICS MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 1102 MOUNTAIN RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-1855
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Country | US
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Telephone | 808-772-3144
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 BROCKMONT AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-1102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TESS KIM
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Credential | LPCC
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Telephone | 808-772-3144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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