MEDICARE: WONMIN KIM COUNSELING AND CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225968050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WONMIN KIM COUNSELING AND CONSULTING LLC

Provider Business Mailing Address
First Line	:	3530 MCCLURE WOODS DR
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8503
Country	:	US
Telephone Number	:	215-767-5337
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 MCCLURE WOODS DR
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8503
Country	:	US
Telephone Number	:	215-767-5337
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	WONMIN KIM
Credential	:	LPC
Telephone Number	:	215-767-5337

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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