Individual provider Active NPI

Sarah Jungsoo Lim, LPC

  • Professional Counselor
  • Fairfax, VA
National Provider Identifier
1265909097
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008155 Issued in VA
Practice address
11204 Waples Mill Rd
Fairfax, VA 22030
Phone
(703) 218-8500
Fax
(703) 359-0463
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PA
Professional Counselor 101YP2500X 0701008155 VA Primary

Addresses

Primary practice location

11204 Waples Mill Rd
Fairfax, VA 22030

Mailing address

11204 Waples Mill Rd
Fairfax, VA 22030
Phone (703) 218-8500

Other names 1

  • Ms. Jung Soo Lim Former name

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

LicenseStateTypeSpecialty
0701008155VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1265909097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SARAH",
        "middle_name": "JUNGSOO",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUNG SOO",
            "last_name": "LIM",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.