NPIMap

Individual provider Active NPI

Colin Lim

  • Clinical Social Worker
  • El Segundo, CA
National Provider Identifier
1861814121
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093953 Issued in MI
Practice address
Los Angeles Air Force Base
483 N Aviation Blvd BLDG 286
El Segundo, CA 90245-2808
Phone
(310) 653-1110
NPI assigned
Jan 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093953 MI Primary

Addresses

Primary practice location

Los Angeles Air Force Base
483 N Aviation Blvd BLDG 286
El Segundo, CA 90245-2808

Mailing address

483 N Aviation Blvd BLDG 286
SBD3-CDG
El Segundo, CA 90245-2808

Other practice location 1

483 N Aviation Blvd Bldg 210
El Segundo, CA 90245-2808
Phone (310) 653-2873

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address colin@spaceforce.hdirect.net Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093953MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United States Space Force CurrentSince Sep 1, 2025 Accepting new patients
Anchorage Vamc Current Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

483 N Aviation Blvd
Bldg 286
El Segundo, CA 90245
Phone (310) 653-1110

Interoperability endpoints

  • Direct secure messaging: colin.lim@direct.va.gov
  • Direct secure messaging: colin@spaceforce.hdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1861814121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD BLDG 286",
            "address_2": "SBD3-CDG",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOS ANGELES AIR FORCE BASE",
            "address_2": "483 N AVIATION BLVD BLDG 286",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "483 N Aviation Blvd Bldg 210",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902452808",
            "country_code": "US",
            "telephone_number": "310-653-2873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "COLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-06",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colin@spaceforce.hdirect.net",
            "affiliation": "N",
            "endpointDescription": "Guardian Resilience Team",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "483 N Aviation Blvd Bldg 286",
            "address_2": "SBD3-CDG",
            "city": "El Segundo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902452808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.