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MRS. REBECCA A.S. KIM LPC
NPI 1417691023
Counselor - Professional in Athens, GA

Active since April 21, 2022Opted out of Medicare · through Apr 11, 2028
105 WHITEHEAD RD # B6, ATHENS, GA 30606(706) 363-0432 Get Directions Write a Review

NPPES record last updated: October 11, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 11, 2023, May 5, 2022, Apr 21, 2022 (3 updates tracked since 2022).

About Mrs. Rebecca A.s. Kim Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. REBECCA A.S. KIM LPC (NPI 1417691023) is an individual professional provider in Athens, Georgia, licensed in Georgia (012929) and active in the NPI registry since April 2022. She has opted out of Medicare through April 11, 2028.

NPPES Registry Identity

NPI1417691023
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. REBECCA A.S. KIMCredential: LPC
Location Address105 WHITEHEAD RD # B6Athens, GA 30606-1554
Mailing AddressPo Box 93Jefferson, GA 30549-0093 · (706) 363-0432
Phone(706) 363-0432
Sole ProprietorYes
Enumeration DateApril 21, 2022
Last NPPES UpdateOctober 11, 20233 updates tracked since enumeration
NPPES CertifiedOctober 11, 2023
✔ NPI 1417691023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · 012929
105 WHITEHEAD RD # B6, Athens, GA 30606
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Rebecca A.s. Kim Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 11, 2024 through April 11, 2028.

Opt-Out Effective DateApril 11, 2024
Opt-Out In Effect ThroughApril 11, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Rebecca Kim's NPI number?

The NPI number for Rebecca Kim is 1417691023. It was assigned to this individual provider in the NPPES registry on April 21, 2022.

Where is Rebecca Kim located?

Rebecca Kim practices at 105 Whitehead Rd # B6, Athens, GA 30606. The listed phone number is (706) 363-0432.

What is Rebecca Kim's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Rebecca Kim enrolled in Medicare?

No. Rebecca Kim has opted out of Medicare through April 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Rebecca Kim was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.