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NPI Code Detail

MEDICARE: LAUREN KIM LCPC, LCPAT

MEDICARE: LAUREN KIM LCPC, LCPAT
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
1221700000XArt TherapistATC279MD
2101YM0800XMental Health CounselorLC11070MD
3101YM0800XMental Health Counselor0701016174VA

General Provider Information

NPI Number : 1215417159
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN KIM LCPC, LCPAT
Provider Business Mailing Address
First Line : 10770 COLUMBIA PIKE STE 300
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4439
Country : US
Telephone Number : 301-507-2197
Fax Number :
Provider Business Practice Location Address
First Line : 10770 COLUMBIA PIKE STE 300
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-4439
Country : US
Telephone Number : 301-508-2197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2018
Last Update Date : 06/07/2026

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