Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jake T Kim, LICSW

Individual provider Clinical Social Worker · NPI 1154636603

Mr. Jake T Kim, LICSW is a Clinical Social Worker in Edmonds, Washington. Qualified in 2010, 16 years ago. Practices with Sequim Counseling LLC, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York and Washington.

Years since qualifying
16
Licensed in
NY, WA
In the registry since
2010
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

7320 216th St SW Ste 200
Edmonds, WA 98026-8006
Phone: (425) 640-4900
Fax: (425) 640-4919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60218364 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 081733 (NY)

Record details

NPI number1154636603
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedAugust 9, 2010
Last updated in NPPESJuly 10, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Sequim Counseling Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Edmonds