Active NPI
Steve J Kim, MA, LCPC
- Professional Counselor
- Crystal Lake, IL
National Provider Identifier
1225453459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-008870
- Practice address
- 390 E Congress Pkwy
Suite J
Crystal Lake, IL 60014-6202 - Phone
- (815) 356-5050
- Fax
- (815) 356-5094
- NPI assigned
- Feb 25, 2014
- Last updated
- Feb 25, 2014
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-008870 | IL | Primary |
Addresses
Primary practice location
390 E Congress Pkwy
Suite J
Crystal Lake, IL 60014-6202
Mailing address
1701 E. Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-008870 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pra Behavioral LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Schaumburg, IL
- NPI 1679546873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393286400000",
"number": "1225453459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E. WOODFIELD ROAD",
"address_2": "SUITE 1000",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601735113",
"telephone_number": "847-240-2211",
"fax_number": "847-240-2418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 E CONGRESS PKWY",
"address_2": "SUITE J",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600146202",
"telephone_number": "815-356-5050",
"fax_number": "815-356-5094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "STEVE",
"middle_name": "J",
"credential": "MA, LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-25",
"last_updated": "2014-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-008870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.