Mikkelsen, Kim Rae

Mikkelsen, Kim Rae is an sole proprietor health care provider with primary practice located at 115 Market St Suite 201, Durham NC 27701-3251. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Mikkelsen, Kim Rae can be contacted via phone (919) 560-5600.

Contact Information

Primary practice address
115 Market St Suite 201 Durham NC 27701-3251
Phone: (919) 560-5600
Fax: (919) 560-3018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X C003728 North Carolina
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1932233079
LBN Legal business name Mikkelsen, Kim Rae
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932233079 NPPES
North Carolina Other 139CP BLUE CROSS

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