SUSAN EUNJI KIM LCSW
NPI 1750857751
Counselor - Mental Health in Riverside, CA

NPI Status: Active since October 17, 2018

Contact Information

11870 PIERCE ST STE 200
RIVERSIDE, CA
ZIP 92505
Phone: (951) 248-4000

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  • Individual
  • Female
  • Years of Experience 9
  • Counselor
  • Mental Health
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SUSAN KIM

This page provides the complete NPI Profile along with additional information for Susan Kim, a provider established in Riverside, California with a medical specialization in Counselor, focusing in mental health and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1750857751 assigned on October 2018. The practitioner's primary taxonomy code is 101YM0800X with license number 114780 (CA). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1750857751
Provider Name
SUSAN EUNJI KIM LCSW
Gender
Female
Entity Type
Individual
Location Address
11870 PIERCE ST STE 200 RIVERSIDE, CA 92505
Location Phone
(951) 248-4000
Mailing Address
11870 PIERCE ST STE 200 RIVERSIDE, CA 92505
Mailing Phone
(951) 248-4000
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
No
Enumeration Date
10-17-2018
Last Update Date
04-18-2024
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A mental health counselor like Susan Kim provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

Location Map

Secondary Locations

  • 13800 Heacock St Ste D111
    Moreno Valley, CA 92553
    (951) 653-1800
  • 520 S Lafayette Park Place 3rd Floor
    Los Angeles, CA 90057
    (213) 252-2100

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers
License No.
114780
License State
CA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YM0800XBehavioral Health & Social Service Providers

Counselor
Mental Health

 
2101YM0800XBehavioral Health & Social Service Providers

Counselor
Mental Health

83283 (CA)

Medicare Participation & PECOS Enrollment Status

Susan Kim is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Susan Kim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3274071691

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240816001838

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for SUSAN EUNJI KIM LCSW

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750857751
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2710016514710
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 6 + 5 + 1 + 4 + 7 + 1 + 0 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1750857751 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1700287091 JENNIFER YI ISERI LMFT
Individual
Marriage & Family Therapist11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
(949) 391-9741
1437603685 LESLIE ROMERO-GALLEGOS
Individual
Social Worker (Clinical)11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
(951) 248-4000
1245746023 JOHANNA PAOLA PAZ
Individual
Marriage & Family Therapist11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
(951) 248-4000
1477012540 STEPHANIE CRISTERNA-CASILLAS
Individual
Counselor (Mental Health)11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
(951) 248-4000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750857751, enumerated in the NPI registry as an "individual" on October 17, 2018

The provider is located at 11870 Pierce St Ste 200 Riverside, Ca 92505 and the phone number is (951) 248-4000

The provider's speciality is Counselor with taxonomy code 101YM0800X with a focus in Mental Health

The provider has more than 9 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

This NPI record was last updated on October 17, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.