Provider Demographics
NPI:1972225258
Name:KIM, JOONSUNG JOSHUA (PHD)
Entity Type:Individual
Prefix:
First Name:JOONSUNG
Middle Name:JOSHUA
Last Name:KIM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 HAMMOND DR
Mailing Address - Street 2:BLDG 10, SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5532
Mailing Address - Country:US
Mailing Address - Phone:404-796-7777
Mailing Address - Fax:470-300-8484
Practice Address - Street 1:750 HAMMOND DR
Practice Address - Street 2:BLDG 10, SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5532
Practice Address - Country:US
Practice Address - Phone:404-796-7777
Practice Address - Fax:470-300-8484
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist