Active NPI
Taeksoo Kim, MSW/LGSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1043798051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LG50082627
- Practice address
- 702 15TH St NE
Washington, DC 20002-4508 - Phone
- (202) 388-8500
- Fax
- (202) 388-8509
- NPI assigned
- Aug 1, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LG50082627 | DC | Primary |
Addresses
Primary practice location
702 15TH St NE
Washington, DC 20002-4508
Mailing address
702 15TH St NE
Washington, DC 20002-4508
Phone (202) 388-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG50082627 | DC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amazing Love Health Services | Past | Accepting new patients | |
| Amazing Love Health Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Washington, DC
- NPI 1437555000
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Washington, DC
- NPI 1730567991
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533081600000",
"number": "1043798051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 15TH ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024508",
"telephone_number": "202-388-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 15TH ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024508",
"telephone_number": "202-388-8500",
"fax_number": "202-388-8509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAEKSOO",
"credential": "MSW/LGSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-01",
"last_updated": "2018-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LG50082627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.