Provider Demographics
NPI:1942727441
Name:KIM, NAOMI AVOLINE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:AVOLINE
Last Name:KIM
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5821
Mailing Address - Country:US
Mailing Address - Phone:267-252-7889
Mailing Address - Fax:
Practice Address - Street 1:555 2ND AVE, BUILDING B, SUITE 101
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426
Practice Address - Country:US
Practice Address - Phone:484-366-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health