MS. KIM RAE MIKKELSEN MSW LCSW NPI 1932233079

NPI Information

NPI: 1932233079
Provider Name: MS. KIM RAE MIKKELSEN, MSW, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
115 MARKET ST
SUITE 201
DURHAM, NC
ZIP 27701
Phone: (919) 560-5600
Get Directions

MS. Kim Rae Mikkelsen, MSW, LCSW is a mental health counselor in Durham, NC. MS. Kim Rae Mikkelsen, MSW, LCSW NPI is 1932233079. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

115 MARKET ST
SUITE 201
DURHAM, NC
ZIP 27701-251
Phone: (919) 560-5600
Fax: (919) 560-3018

The enumeration date for this NPI number is 3/14/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	101YP2500X	Counselor	Professional			X
3	104100000X	Social Worker				X
4	1041C0700X	Social Worker	Clinical	C003728	NORTH CAROLINA	X
5	171M00000X	Case Manager/Care Coordinator				X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	139CP	OTHER	NORTH CAROLINA	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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