Active NPI
Sally Kim, LCPC
- Professional Counselor
- Gaithersburg, MD
National Provider Identifier
1154020071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC15113
- Practice address
- 504 Main St
Gaithersburg, MD 20878-5587 - Phone
- (301) 591-6830
- NPI assigned
- Feb 28, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP11987 | MD | |
| Professional Counselor | 101YP2500X | LC15113 | MD | Primary |
Addresses
Primary practice location
504 Main St
Gaithersburg, MD 20878-5587
Mailing address
8010 Gramercy Blvd Apt 435
Rockville, MD 20855-2365
Phone (301) 906-9804
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 |
|---|---|---|---|
| LC15113 | MD | MD | Professional Counselor |
| LGP11987 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One Mental Health LLC - Rockville | Professional | Past | Accepting new patients |
| Kyn Health | 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.
-
- Mental Health Counselor
- Rockville, MD
- NPI 1801526587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1154020071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8010 GRAMERCY BLVD APT 435",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208552365",
"telephone_number": "301-906-9804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 MAIN ST",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208785587",
"telephone_number": "301-591-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SALLY",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-28",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP11987",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC15113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.