Provider Demographics
NPI:1396151106
Name:KIM, CECILIA (LMFT)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 W COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3918
Mailing Address - Country:US
Mailing Address - Phone:393-432-5217
Mailing Address - Fax:303-432-5260
Practice Address - Street 1:9485 W COLFAX AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215
Practice Address - Country:US
Practice Address - Phone:393-432-5217
Practice Address - Fax:303-432-5260
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist