Healthcare Provider Details

I. General information

NPI: 1164703609
Provider Name (Legal Business Name): EUN MI KIM LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EUN MI KIM LPC

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 LITITZ PIKE
LANCASTER PA
17601-3723
US

IV. Provider business mailing address

2603 LITITZ PIKE
LANCASTER PA
17601-3723
US

V. Phone/Fax

Practice location:
  • Phone: 717-315-4371
  • Fax: 833-946-3162
Mailing address:
  • Phone: 717-315-4371
  • Fax: 833-946-3162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006001
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: