Individual
JINSE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
14631 LEE HWY STE 313, CENTREVILLE, VA 20121-5834
(703) 650-9099
Mailing address
6538 CREEK RUN DR, CENTREVILLE, VA 20121-3865
(703) 531-9401
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008862
VA
101YP2500X
Professional Counselor
LC10007
MD
Other
Enumeration date
11/06/2019
Last updated
09/23/2023
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