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General NPI Number Information
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NPI Number | 1912144437
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Entity Type | Individual
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Provider Name | JAHYANG KOO KIM LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 140-15B SANFORD AVE, 2ND FLOOR
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City | FLUSHING
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State | NY
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Zip | 11355
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Country | US
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Telephone | 718-358-8288
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Fax | 718-358-5265
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Provider Business Mailing Address
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Address Line | 194 WEBSTER RD
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City | SCARSDALE
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State | NY
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Zip | 10583-5932
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Country | US
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Telephone | 914-262-6943
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 076140
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05497600
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License Number State | NJ
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