MR. JOHN B. KIM LCSW NPI 1417990466

NPI Information

  • NPI: 1417990466
  • Provider Name: MR. JOHN B. KIM, LCSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 91-2301 FORT WEAVER RD
    EWA BEACH, HI
    ZIP 96706
  • Phone: (808) 671-8511

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NPI Details

MR. John B. Kim, LCSW is a clinical social worker in Ewa Beach, HI. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MR. John B. Kim, LCSW NPI is 1417990466. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

91-2301 FORT WEAVER RD
EWA BEACH, HI
ZIP 96706-602
Phone: (808) 671-8511
Fax: (808) 676-8035

The enumeration date for this NPI number is 6/14/2006 and was last updated on 2/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalLCSW-3089HAWAIIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1554825MEDICAIDHAWAII
255482501OTHERHAWAIIALOHACARE
30000248385OTHERHAWAIIHMSA
4990298651-96706-C002OTHERHAWAIITRICARE
5Q17777MEDICARE UPINHAWAII
6788861OTHERHAWAIIUNIVERSITY HEALTH ALLIANC
756826MEDICARE ID-TYPE UNSPECIFIEDHAWAII

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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