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

Taeryeng Gim, CDPT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1992299069

Taeryeng Gim, CDPT is a Mental Health Counselor in Monroe, Washington. Qualified in 2020, 6 years ago. Practices with International Community Health Services, a 94-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
6
Licensed in
WA
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

14090 Frylnds Blvd SE Ste 347
Monroe, WA 98272-2760
Phone: (360) 805-3122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9930 Evergreen Way Ste Z150, Everett, WA 98204-3889 — (425) 347-5152

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LH61428482 (WA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CP61044121 (WA)

Record details

NPI number1992299069
Entity typeIndividual (Type 1)
GenderFemale
Credentials CDPT
Sole proprietorNo
NPI enumeratedJune 21, 2018
Last updated in NPPESJuly 11, 2023
Certification dateJuly 11, 2023
Mailing addressPo Box 34703, Seattle, WA 98124-1703

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice International Community Health Services — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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