JAEYOUNG KIM (NPI# 1780207605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780207605 |
| Entity Type | Individual |
| Full Name | JAEYOUNG KIM |
| Practice Address |
802 E Gorham St Madison WI 53703-1524 |
| Mailing Address |
25 Kessel Ct Ste 105 Madison WI 53711-6227 |
| Practice Telephone | 6082804700 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639735723 | Jaeyoung Kim | Dentist | 4754 Commercial Dr Ste 2, New Hartford, NY 13413-6205 | 2019-05-14 |
| 1811376668 | Jaeyoung Kim | Acupuncturist | 2316 Artesia Blvd, Suite E, Redondo Beach, CA 90278-3187 | 2015-05-27 |
| Street Address |
802 E GORHAM ST |
| City | MADISON |
| State | WI |
| Zip Code | 53703-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750500062 | Linda Wuestenberg | Counselor | 802 E Gorham St, Madison, WI 53703-1524 | 2007-04-25 |
| 1275132847 | Patrick Momoh Fau | Counselor | 802 E Gorham St, Madison, WI 53703-1524 | 2020-10-23 |
| 1457950263 | Theresa Scheuermann | Registered Nurse | 802 E Gorham St, Madison, WI 53703-1524 | 2020-10-22 |
| 1275158636 | Muna Bhattarai | Rehabilitation Counselor | 802 E Gorham St, Madison, WI 53703-1524 | 2020-06-11 |
| 1225697568 | Hannah Elizabeth Fry | Case Manager/Care Coordinator | 802 E Gorham St, Madison, WI 53703-1524 | 2019-06-11 |
| 1114480928 | Nicole Roehl | Case Manager/Care Coordinator | 802 E Gorham St, Madison, WI 53703-1524 | 2019-04-09 |
| 1750844569 | Logan Potvin | Case Manager/Care Coordinator | 802 E Gorham St, Madison, WI 53703-1524 | 2019-04-09 |
| 1194288902 | Tyler Douglas | Case Manager/Care Coordinator | 802 E Gorham St, Madison, WI 53703-1524 | 2019-04-09 |
| 1932665205 | Maya Coleen Arora | Case Manager/Care Coordinator | 802 E Gorham St, Madison, WI 53703-1524 | 2019-02-12 |
| 1831653302 | Daniel Portice | Registered Nurse | 802 E Gorham St, Madison, WI 53703-1524 | 2019-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689291254 | Lynne's Moc, LLC | Optometrist | 512 State Street, Madison, WI 53703 | 2020-06-30 |
| 1407327844 | Deborah Ann Pape | Psychologist | 350 S. Hamilton St., Unit 504, Madison, WI 53703 | 2018-12-11 |
| 1336660216 | Kevin Shuai Lian | Radiology | 420 W Dayton St Unit 1142, Madison, WI 53703 | 2017-06-30 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1093193690 | Ashley Przybilla | Pediatrics | Group Health Cooperative of South Central Wisconsin, 675 West Washington Avenue, Madison, WI 53703 | 2015-05-14 |
| 1043606841 | Kevin P Emmerich | Emergency Medicine | 390 West Johnson St, Madison, WI 53703 | 2015-04-09 |
| 1376983155 | Ann Renee Wingate | Counselor | 16 N. Hancock Street, Hancock Center, Madison, WI 53703 | 2013-06-26 |
| 1013269398 | See Inc | Optometrist | 437 State St, Madison, WI 53703 | 2012-10-10 |
| 1518243237 | Nathan Dufault | Specialist/Technologist | 305 S. Livingston St., Madison, WI 53703 | 2011-10-26 |
| 1518264142 | Candice Y Lewis | Health Maintenance Organization | 675 W.washington Ave. Group Health Cooperative of South, Madison, WI 53703 | 2011-02-17 |
| Find all providers in zip 53703 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710591086 | Carrie Allen | Counselor | 222 Kyser Blvd Apt 73, Madison, AL 35758-2307 | 2020-09-03 |
| 1548872765 | Kelly Kendricks | Counselor | 2002 Atwood Ave Ste 225, Madison, WI 53704-5382 | 2020-08-19 |
| 1740803097 | Megan Gour | Counselor | 8102 Wellness Way, Madison, WI 53719-8800 | 2020-05-21 |
| 1578197141 | Nicole Danielle Morra | Counselor | 141 Durham Rd Ste 19, Madison, CT 06443-2657 | 2020-02-23 |
| 1982236741 | Jolin Mitchel | Counselor | 437 S Yellowstone Dr Ste 219, Madison, WI 53719-1061 | 2020-02-10 |
| 1346880127 | Tree of Life Treatment Services | Counselor | 437 S Yellowstone Dr Ste 200, Madison, WI 53719-2902 | 2020-01-09 |
| 1720623226 | Reflections Mental Health LLC | Counselor | 2802 Coho St Ste 203, Madison, WI 53713-4521 | 2019-11-08 |
| 1740822287 | Diamond Jones | Counselor | 2093 W Us 90, Madison, FL 32340-4308 | 2019-10-16 |
| 1457819617 | Emma Coleen Tagariello | Counselor | 170 Ridgedale Ave, Madison, NJ 07940-1220 | 2019-03-06 |
| 1144785940 | Vallis LLC | Counselor | 814 Palmer Rd Ste B4, Madison, AL 35758-3185 | 2019-02-05 |
| Find all providers in MADISON | ||||
Please comment or provide details below to improve the information on JAEYOUNG KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.