Ji Min Kim, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2150 Manchester Rd
Wheaton, IL 60187-4598

Phone

(630) 752-9874

NPI assigned

Aug 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1568199719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2463 S ARCHER AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161844",
            "telephone_number": "571-355-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 MANCHESTER RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874598",
            "telephone_number": "630-752-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI MIN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "willowclinical@therapysecure.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2150 Manchester Rd",
            "city": "Wheaton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601874598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiebles Psychology Services LLC (Kiebles Psychology Services)
• Natasha Kiefer, AMFT
• Timothy J. Kietzman, M.D.
• Erica Kight, DDS
• Ethan Zachary Kile
• Jin-a Kim, ANP
• Sage Kim, MA, LPC
• Sharon Kim, LPC
• Steve Jin Hyung Kim, MD
• M Colleen King, LCSW CADC

• Mental Health Counselor in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.