Healthcare Provider Details

I. General information

NPI: 1053266031
Provider Name (Legal Business Name): LK ART THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10770 COLUMBIA PIKE STE 300
SILVER SPRING MD
20901-4439
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 300
SILVER SPRING MD
20901-4439
US

V. Phone/Fax

Practice location:
  • Phone: 301-507-2197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAUREN KIM
Title or Position: OWNER
Credential: LCPAT, LCPC
Phone: 301-507-2197