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General NPI Number Information
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NPI Number | 1245756527
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Entity Type | Individual
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Provider Name | JENNIFER LEE KIM LPC ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 4408 SPICEWOOD SPRINGS RD STE 111
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City | AUSTIN
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State | TX
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Zip | 78759-8504
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Country | US
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Telephone | 512-655-3878
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 S LAKELINE BLVD APT 1534
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City | CEDAR PARK
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State | TX
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Zip | 78613-2023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88049
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License Number State | TX
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