Active NPI
Eunice E Kim, LCSW
- Clinical Social Worker
- Covina, CA
National Provider Identifier
1447424643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS24296
- Practice address
- 1175 E Garvey St
Ste 102
Covina, CA 91724-3677 - Phone
- (626) 967-6421
- Fax
- (626) 967-9670
- NPI assigned
- Apr 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS24296 | CA | Primary |
Addresses
Primary practice location
1175 E Garvey St
Ste 102
Covina, CA 91724-3677
Mailing address
1175 E Garvey St
Ste 102
Covina, CA 91724-3677
Phone (626) 967-6421
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 |
|---|---|---|---|
| LCS24296 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Hope Christian Counseling Foundation, Inc | Past | Accepting new patients | |
| New Hope Christian Center, Inc | 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.
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1891855433
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1750441291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1447424643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 E GARVEY ST",
"address_2": "STE 102",
"city": "COVINA",
"state": "CA",
"postal_code": "917243677",
"telephone_number": "626-967-6421",
"fax_number": "626-967-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 E GARVEY ST",
"address_2": "STE 102",
"city": "COVINA",
"state": "CA",
"postal_code": "917243677",
"telephone_number": "626-967-6421",
"fax_number": "626-967-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "EUNICE",
"middle_name": "E",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-17",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS24296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.