Individual provider Active NPI

Katherine Heesu Kim, LCPC

  • Professional Counselor
  • Catonsville, MD
National Provider Identifier
1336490671
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC4650 Issued in MD
Practice address
800 Ingleside Ave
Catonsville, MD 21228-1722
Phone
(410) 744-5937
Fax
(410) 744-4674
NPI assigned
Sep 26, 2012
Last updated
Sep 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC4650 MD Primary

Addresses

Primary practice location

800 Ingleside Ave
Catonsville, MD 21228-1722

Mailing address

1040 Park Ave
Suite 103
Baltimore, MD 21201-5633
Phone (410) 837-3977

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
LC4650MDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1336490671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE",
            "address_2": "SUITE 103",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015633",
            "telephone_number": "410-837-3977",
            "fax_number": "410-752-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 INGLESIDE AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281722",
            "telephone_number": "410-744-5937",
            "fax_number": "410-744-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KATHERINE",
        "middle_name": "HEESU",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC4650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.