Han Soo Kim, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60971499 Issued in WA

Practice address

4629 168TH St SW Ste E
Lynnwood, WA 98037-8640

Phone

(425) 776-1290

NPI assigned

Jul 15, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment Care Compare group NPD
• Asian American Chemical Dependency Treatment Services

  dba Asian Counseling Treatment Services

  • Community/Behavioral Health Agency
  • Lakewood, WA
  • NPI 1144451048
  NPD
• Asian American Chemical Dependency Treatment Services

  dba Asian Counseling Treatment Services

  • Community/Behavioral Health Agency
  • Lynnwood, WA
  • NPI 1821382870
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1033761408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992418",
            "telephone_number": "253-302-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 168TH ST SW STE E",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378640",
            "telephone_number": "425-776-1290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9102 Bridgeport Way SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992418",
            "country_code": "US",
            "telephone_number": "253-302-3826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAN SOO",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60971499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher H Kim, PHARM D
• Chul Kim
• Daniel Taeho Kim, D.C.
• David Ung Kim, M.D.
• Eric Kim
• Hyunjun Kim, D.C
• Jin Ho Kim, EAMP, LAC.
• Jiyoung Kim, ND, LAC
• Jooyong V Kim, RPH
• Jung Kim, RPH

• Mental Health Counselor in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.