Provider Demographics
NPI:1225922842
Name:KIM, SUMIN (LAPC, ATR)
Entity type:Individual
Prefix:MS
First Name:SUMIN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LAPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 EDGEVALE DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2302
Mailing Address - Country:US
Mailing Address - Phone:872-222-0093
Mailing Address - Fax:
Practice Address - Street 1:3231 S HALSTED ST STE 213
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-6613
Practice Address - Country:US
Practice Address - Phone:312-945-6052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health