Individual provider · Type 1 NPI

So Yeon Park

Clinical Social Worker · Elmhurst, NY

NPI number 1457500761 Active

Practice location

8708 Justice Ave Ste C7
Elmhurst, NY 11373-4590

Call (718) 899-9810 Map

Fax (718) 899-9699

Mailing address

255 W 75th St Apt 5C
New York, NY 10023-1740

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XNone listed
Clinical Social Worker Primary 1041C0700X081393 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1457500761

So Yeon Park's National Provider Identifier is 1457500761, issued on Sep 10, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Elmhurst, NY. The record was last updated on Jun 22, 2010.