MEDICARE: GRACE KIM LCSW

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
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	CSW006837	GA

General Provider Information

NPI Number	:	1477218212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE KIM LCSW

Provider Business Mailing Address
First Line	:	235 E PONCE DE LEON AVE STE 330
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-3754
Country	:	US
Telephone Number	:	470-601-7870
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 E PONCE DE LEON AVE STE 330
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-3754
Country	:	US
Telephone Number	:	470-601-7870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2021
Last Update Date	:	03/01/2024

Similar Medicare Providers

1114869336 — RHP HOMES, LLC
Practice Location Address:

1202 19TH AVE SW
DECATUR, AL
35601-3754

Practice Phone: 256-565-2248
Practice Fax:

1558030791 — LENISSA VILHENA BARBOSA FALCAO LCSW
Practice Location Address:

160 CLAIREMONT AVE STE 400
DECATUR, GA
30030-2546

Practice Phone: 404-500-4266
Practice Fax: 404-500-4283

1265171185 — ELIZABETH RHEA LCSW, LICSW
Practice Location Address:

119 E COURT SQ STE 210
DECATUR, GA
30030-2522

Practice Phone: 404-369-0736
Practice Fax:

1750225363 — MEGAN SIMMONS LMT
Practice Location Address:

125 E TRINITY PL STE 306
DECATUR, GA
30030-3360

Practice Phone: 470-524-2077
Practice Fax:

1043169691 — TAJANA TATA PRESIDENT LPC
Practice Location Address:

160 CLAIREMONT AVE STE 400
DECATUR, GA
30030-2546

Practice Phone: 404-500-4266
Practice Fax: 404-500-4283

1912203076 — VONETTA MICHELLE DOTSON PHD
Practice Location Address:

2752 E PONCE DE LEON AVE STE G
DECATUR, GA
30030-2714

Practice Phone: 404-482-3898
Practice Fax:

Directions to “ GRACE KIM LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.