Active NPI
Michelle Haesun Kim
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1619533650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 125828
- Practice address
- 6762 Lexington Ave
Los Angeles, CA 90038-1217 - Phone
- (323) 380-7590
- NPI assigned
- May 15, 2019
- 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 | 125828 | CA | Primary |
Addresses
Primary practice location
6762 Lexington Ave
Los Angeles, CA 90038-1217
Mailing address
PO Box 8493
La Crescenta, CA 91224-0493
Phone (818) 281-3754
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1619533650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8493",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912240493",
"telephone_number": "818-281-3754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6762 LEXINGTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900381217",
"telephone_number": "323-380-7590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MICHELLE",
"middle_name": "HAESUN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "125828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.