Active NPI
Audrey Kim
- Counselor
- Lombard, IL
National Provider Identifier
1922800473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.017278
- Practice address
- 1919 S Highland Ave Ste 200D
Lombard, IL 60148-6174 - Phone
- (708) 566-6516
- NPI assigned
- Mar 26, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.017278 | IL | Primary |
Addresses
Primary practice location
1919 S Highland Ave Ste 200D
Lombard, IL 60148-6174
Mailing address
1046 Happ Rd
Northfield, IL 60093-1009
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.017278 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lotus Bloom Psychology PLLC | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lotus Bloom Psychology
- Clinical Psychologist
- Lombard, IL
- NPI 1508531203
Counselor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1922800473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1046 HAPP RD",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600931009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S HIGHLAND AVE STE 200D",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486174",
"telephone_number": "708-566-6516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "AUDREY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-26",
"last_updated": "2025-03-26",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.017278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.