Jina Park, LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JINA PARK, LCSW LLC

Practice address

24 W Railroad Ave Unit 136
Tenafly, NJ 07670-1752

Phone

(562) 708-6558

NPI assigned

May 18, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jina Park, LCSWNPI 1942776133

Title

Owner

Phone

(562) 708-6558

Specialties & licenses 1

Addresses

Other names 1

• Rise Psychotherapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jina Park, LCSW

  • Clinical Social Worker
  • Jersey City, NJ
  • NPI 1942776133
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715990400000",
    "number": "1003665282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 W RAILROAD AVE UNIT 136",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701752",
            "telephone_number": "562-708-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W RAILROAD AVE UNIT 136",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701752",
            "telephone_number": "562-708-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JINA PARK, LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-708-6558",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rise Psychotherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joini James
• Robert Jawetz, MD
• Sheryl Jawetz, MD
• Jewish Community Center on the Palisades
• Jewish Community Center on the Palisades
• JNJC Medical LLC
• Diane L Jonas-Feit, DMD
• Kento Kamiyama, P.T., D.P.T
• Karishma Kancherla, M.D.
• Elena Kardonsky, LCSW

• Clinical Social Worker in Tenafly, NJ
• Providers in Tenafly, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.