STEPHANIE KIM LSW
NPI 1396547154
Social Worker in Gurnee, IL
About Stephanie Kim Lsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHANIE KIM LSW (NPI 1396547154) is an individual social worker in Gurnee, Illinois and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stephanie Kim Lsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stephanie Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Palatine, IL 60067
- Reassigned Medicare billing, Illinois enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stephanie Kim's NPI number?
The NPI number for Stephanie Kim is 1396547154. It was assigned to this individual provider in the NPPES registry on March 25, 2025.
Where is Stephanie Kim located?
Stephanie Kim practices at 1800 Nations Dr Ste 211, Gurnee, IL 60031. The listed phone number is (224) 424-4194.
What is Stephanie Kim's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Stephanie Kim enrolled in Medicare?
Yes. Stephanie Kim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stephanie Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stephanie Kim reassigns Medicare benefits to Mindful Support PLLC (Palatine, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephanie Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stephanie Kim was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Stephanie Kim, LSW · NPI 1396547154
Social Worker provider in Gurnee, Illinois. Individual provider, active in the CMS NPPES registry since March 25, 2025.
## Identity
- **NPI:** 1396547154 (Entity type: Individual)
- **Enumerated:** March 25, 2025
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1800 NATIONS DR STE 211, Gurnee, IL 60031-9173
- **Phone:** (224) 424-4194
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mindful Support PLLC (NPI 1003689217, Palatine, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** March 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1396547154) · Data from the CMS NPPES public registry.