Individual
JOHNNY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
677 CRAIG RD STE 214, CREVE COEUR, MO 63141-7125
(314) 669-1305
Mailing address
6036 WESTMINSTER PL, SAINT LOUIS, MO 63112-1412
(214) 551-0909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
149.028195
IL
101YM0800X
Mental Health Counselor
Primary
2023038331
MO
101YM0800X
Mental Health Counselor
—
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Other
Enumeration date
07/01/2021
Last updated
12/12/2024
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