Jason Kim, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

62816 Issued in TX

Practice address

200 Flower Mound Rd
Flower Mound, TX 75028-3421

Phone

(214) 513-7707

NPI assigned

Feb 5, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Newlife Bridge Counseling PLLC

  • Professional Counselor
  • Flower Mound, TX
  • NPI 1043688369
  NPD Authorized official

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1114259892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FLOWER MOUND RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283421",
            "telephone_number": "214-513-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FLOWER MOUND RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283421",
            "telephone_number": "214-513-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JASON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "62816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89583L",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nazish Khurram, M.D.
• Laureen Kiama, PHARMD
• Sanketh Kichena, DO
• Kathlyn Kight, MD
• Christopher Jinwoo Kim, DPT
• Jin Kim, D.C.
• Joseph M Kim, M.D.
• Kyung Ha Kim, DDS
• May Kim, M.D.
• Stephen Hojong Kim, D.D.S., M.S.

• Professional Counselor in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.