Young Rae Shim, PH. D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009531 Issued in GA

Practice address

3000 Langford Rd
Peachtree Corners, GA 30071-1521

Phone

(216) 272-1986

NPI assigned

Jun 14, 2010

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1669793782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 LANGFORD RD STE 300",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300714772",
            "telephone_number": "216-272-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LANGFORD RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300711521",
            "telephone_number": "216-272-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "YOUNG",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009531",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Seagren
• Christopher Robert Sellars, D.O.
• Yassmin Shariff, DO
• Yuki Shida, LMFT
• Shieh ABA, LLC
• Hyunsu Shin
• Michael Yong Shin, D.P.T
• Shorna Lee Yanique Shirley
• Patricia Ann Shively, MD
• Benjamin Shivers, DC

• Professional Counselor in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.