MEDICARE: KALEIDOSCOPIC MINDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1699627356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALEIDOSCOPIC MINDS

Provider Business Mailing Address
First Line	:	PO BOX 1225
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-1225
Country	:	US
Telephone Number	:	917-426-3587
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 OLD PALISADE RD APT 3510
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-7027
Country	:	US
Telephone Number	:	917-426-3587
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. HONG SEON KIM
Credential	:	PH.D.
Telephone Number	:	917-426-3587

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “KALEIDOSCOPIC MINDS ” Practice Location

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