Alice Kim

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2964 Peachtree Rd NW Ste 760
Atlanta, GA 30305-2220

Phone

(236) 924-0404

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 15, 2024 through Mar 15, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1265039804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 CREEK BEND LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 PEACHTREE RD NW STE 760",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052220",
            "telephone_number": "236-924-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6095 Pine Mountain Rd NW Ste 105",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301523332",
            "country_code": "US",
            "telephone_number": "678-217-7529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariae Kilroy, NURSE PRACTITIONER
• Aaron J Kilts, PSY.D.
• Kim Oppenheimer, PHD, PC
• Abby Ae-Kyung Kim, MSW
• Alexandrea Hyunjee Kim, MD
• Alyssa Kim
• Amanda Jennifer Kim
• Amy E Kim, MD
• Andrew Hyun Kim, DPT
• Angelique N Kim, PT

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.