Provider Demographics
NPI:1588230148
Name:KIM, YOU MI JO (LCSW)
Entity Type:Individual
Prefix:
First Name:YOU MI
Middle Name:JO
Last Name:KIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LANGFORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4772
Mailing Address - Country:US
Mailing Address - Phone:770-906-3799
Mailing Address - Fax:
Practice Address - Street 1:3000 LANGFORD RD STE 300
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071-4772
Practice Address - Country:US
Practice Address - Phone:770-906-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0075851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical