BONNIE MIJA KIM (LCPC) – Counselor, NPI 1336011287

BONNIE MIJA KIM (LCPC) is a healthcare provider. based in Rolling meadows, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC. They hold a License No. 180.01.14880 (IL). The NPI Number for BONNIE MIJA KIM (LCPC) is 1336011287

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
BONNIE MIJA KIM (LCPC)
NPI
1336011287
Phone
(847) 917-9974
Address
4200 EUCLID AVE STE 104
Enumeration Date
20 September 2025
Last Update Date
20 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8479179974
Graduation Year
2013 (13 years ago)
PAC ID
3971085291
Group Practice PAC ID
2163918723
Professional Enrollment ID
I20260305002727
Address ID
IL600082083RO4200XAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,356 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for BONNIE MIJA KIM (LCPC)

  • 4200 EUCLID AVE STE 104

    ROLLING MEADOWS, IL 600082083

    Phone: (847) 917-9974

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-05

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260305002727IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60008)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163918723View full group profile
NameSpecialtyState
Mental Health CounselorIL

Reviews

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Frequently asked questions

What NPI should I save for BONNIE MIJA KIM (LCPC)?
Save NPI 1336011287 if you need a stable reference for BONNIE MIJA KIM (LCPC).
Is BONNIE MIJA KIM (LCPC)'s NPI currently valid?
The extract we use shows BONNIE MIJA KIM (LCPC) as active.
Can you summarize BONNIE MIJA KIM (LCPC)'s specialty in plain language?
Clinically, the directory lists BONNIE MIJA KIM (LCPC) with Counselor. Clinical services aligned with this taxonomy classification.
What location shows for BONNIE MIJA KIM (LCPC)?
We surface Rolling Meadows, Illinois for BONNIE MIJA KIM (LCPC) based on available NPPES addresses.
How can I contact BONNIE MIJA KIM (LCPC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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