Provider Demographics
NPI:1972095743
Name:KIM, LUCY CHOI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:CHOI
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 1:136 S CLARK DR APT 4
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3253
Mailing Address - Country:US
Mailing Address - Phone:310-936-6616
Mailing Address - Fax:
Practice Address - Street 1:415 N CAMDEN DR STE 117
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4437
Practice Address - Country:US
Practice Address - Phone:310-936-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical