KINTSUGI MENTAL HEALTH LLC
NPI 1679336077
Psychologist - Counseling in Madison, WI

Active since January 30, 2024
119 MARTIN LUTHER KING JR BLVD STE LL-20, MADISON, WI 53703(608) 291-3586 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kintsugi Mental Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINTSUGI MENTAL HEALTH LLC (NPI 1679336077) is a healthcare organization registered as a counseling in Madison, Wisconsin and active in the NPI registry since January 2024. The organization maintains a secondary practice location in Madison and lists Jaime Lam, Owner/licensed Psychologist, as its authorized official.

NPPES Registry Identity

NPI1679336077
Entity TypeOrganization
Primary Taxonomy103TC1900X
Legal Business NameKINTSUGI MENTAL HEALTH LLC
Location Address119 MARTIN LUTHER KING JR BLVD STE LL-20Madison, WI 53703-3355
Mailing Address5902 Tolman TerMadison, WI 53711-3360 · (781) 698-9171
Organization SubpartNo
Authorized OfficialJaime LamOwner/licensed Psychologist · (781) 698-9171
Enumeration DateJanuary 30, 2024
Last NPPES UpdateMarch 6, 2024
NPPES CertifiedMarch 6, 2024
✔ NPI 1679336077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · CounselingBehavioral Health & Social Service Providers
Taxonomy Code103TC1900X
Definition
A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
119 MARTIN LUTHER KING JR BLVD STE LL-20, Madison, WI 53703

Secondary Practice Location 1

Location 15902 Tolman TerMadison, WI 53711-3360 · Phone (781) 698-9171

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kintsugi Mental Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kintsugi Mental Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1932684735
119 MARTIN LUTHER KING JR BLVD
Madison, WI 53703
(608) 291-3586
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kintsugi Mental Health LLC's NPI number?

The NPI number for Kintsugi Mental Health LLC is 1679336077. It was assigned to this organization in the NPPES registry on January 30, 2024.

Where is Kintsugi Mental Health LLC located?

Kintsugi Mental Health LLC is located at 119 Martin Luther King Jr Blvd Ste Ll-20, Madison, WI 53703. The listed phone number is (608) 291-3586.

What is Kintsugi Mental Health LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Counseling, with taxonomy code 103TC1900X.

Is Kintsugi Mental Health LLC enrolled in Medicare?

Yes. Kintsugi Mental Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kintsugi Mental Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Kintsugi Mental Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kintsugi Mental Health LLC accept?

Health plans from Dean Health Plan and Quartz list Kintsugi Mental Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kintsugi Mental Health LLC was last updated on March 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.