MINA KIM
NPI 1801559133
Psychologist in Fairfax, VA

Active since October 13, 2021PECOS Enrolled
8280 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031(571) 472-4300 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2026, Oct 13, 2021 (2 updates tracked since 2021).

About Mina Kim NPPES

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

MINA KIM (NPI 1801559133) is an individual psychologist in Fairfax, Virginia and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2018).

NPPES Registry Identity

NPI1801559133
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMINA KIM
Location Address8280 WILLOW OAKS CORPORATE DRFairfax, VA 22031-4518
Mailing Address8280 Willow Oaks Corporate DrFairfax, VA 22031-4518
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 2018
Enumeration DateOctober 13, 2021
Last NPPES UpdateMay 29, 20262 updates tracked since enumeration
NPPES CertifiedMay 29, 2026
NPI 1801559133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

8280 WILLOW OAKS CORPORATE DR, Fairfax, VA 22031

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mina Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375021223
PECOS Enrollment IDI20260202000527
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Technician
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Behavior Technician
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Behavior Technician
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Counselor (Professional)
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Social Worker (Clinical)
8280 WILLOW OAKS CORPORATE DR, SUITE 600
FAIRFAX, VA 22031
Home Health
8280 WILLOW OAKS CORPORATE DR, SUITE 600
FAIRFAX, VA 22031
Nurse Practitioner (Family)
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Home Health Aide
8280 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031

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 Mina Kim's NPI number?

The NPI number for Mina Kim is 1801559133. It was assigned to this individual provider in the NPPES registry on October 13, 2021.

Where is Mina Kim located?

Mina Kim practices at 8280 Willow Oaks Corporate Dr, Fairfax, VA 22031. The listed phone number is (571) 472-4300.

What is Mina Kim's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Mina Kim enrolled in Medicare?

Yes. Mina Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mina Kim was last updated on May 29, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.