THERESE MARIE KIM (LICSW) – Counselor, NPI 1053839266

THERESE MARIE KIM (LICSW) is a healthcare provider. based in Northampton, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. LICSW124905 (MA). The NPI Number for THERESE MARIE KIM (LICSW) is 1053839266

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
THERESE MARIE KIM (LICSW)
NPI
1053839266
Phone
(413) 210-0245
Address
125 BARRETT ST
Enumeration Date
7 September 2017
Last Update Date
3 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5088806666
Graduation Year
2018 (8 years ago)
PAC ID
3971981341
Group Practice PAC ID
6901866706
Professional Enrollment ID
I20220526001206
Address ID
MA027803243TA30XXXGRNX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

Provider Addresses for THERESE MARIE KIM (LICSW)

  • 125, Barrett Street, Northampton, Hampshire County, Massachusetts, 1060, United States

    NORTHAMPTON, MA 010601703

    Phone: (413) 210-0245

    Fax: (413) 288-7116

    Type: Mailing

  • 125 BARRETT ST

    NORTHAMPTON, MA 010601703

    Phone: (413) 210-0245

    Fax: (413) 288-7116

    Type: Location

  • 130, Maple Street, South End, Springfield, Hampden County, Massachusetts, 01105, United States

    SPRINGFIELD, MA 011032202

    Phone: (413) 737-4455

    Fax: (413) 737-4455

    Type: Location

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: 2022-05-26

PECOS data refreshed: 2026-05-27

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
I20220526001206IClinical Social WorkerMATBD

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 01060)

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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: 6901866706View full group profile
NameSpecialtyState
Nurse PractitionerTN
Clinical Social WorkerMA
Mental Health CounselorRI
-MA
Mental Health CounselorMA
Mental Health CounselorMA
Clinical Social WorkerMA
-MA
Mental Health CounselorMA
Clinical Social WorkerMA

Reviews

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Frequently asked questions

What NPI should I save for THERESE MARIE KIM (LICSW)?
Save NPI 1053839266 if you need a stable reference for THERESE MARIE KIM (LICSW).
Is THERESE MARIE KIM (LICSW) active in the national directory?
THERESE MARIE KIM (LICSW)'s public NPI profile is in an active state.
Does THERESE MARIE KIM (LICSW) list a primary specialty?
If you are matching referrals, note Counselor for THERESE MARIE KIM (LICSW). Clinical services aligned with this taxonomy classification.
What location metadata exists for THERESE MARIE KIM (LICSW)?
The page summarizes Northampton, Massachusetts for THERESE MARIE KIM (LICSW); expand the address list for detail.
What if Northampton, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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