Provider Demographics
NPI:1548812498
Name:KIM, DONG HEE (LCSW)
Entity type:Individual
Prefix:
First Name:DONG
Middle Name:HEE
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 1:6301 MARY TODD CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-3546
Mailing Address - Country:US
Mailing Address - Phone:703-581-8230
Mailing Address - Fax:
Practice Address - Street 1:6301 MARY TODD CT
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-3546
Practice Address - Country:US
Practice Address - Phone:703-581-8230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0881091041C0700X
VA09040109431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical