Individual provider Active NPI

David Hak Kim, LMHC

  • Mental Health Counselor
  • Issaquah, WA
National Provider Identifier
1902332505
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61284759 Issued in WA
Practice address
751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201
Phone
(425) 394-0700
Fax
(425) 394-0701
NPI assigned
May 3, 2017
Last updated
May 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61284759 WA Primary

Addresses

Primary practice location

751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2240332MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111004978 WA Practitioner - Mental Health Counselor 0345691523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

751 NE Blakely Dr
Suite 5010
Issaquah, WA 98029-6201
Phone (425) 394-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Jan 1, 2024 Accepting new patients
Swedish Health Services Current Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Ste 5010
Issaquah, WA 98029
Phone (425) 394-0700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1902332505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR STE 5010",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-394-0700",
            "fax_number": "425-394-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "HAK",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61284759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2240332",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.