Yeddi Park, MSW
Individual provider Active NPI School Social Worker · Leonia, NJ
NPI 1013237353 · NPPES record last updated Oct 16, 2010
Key facts
- NPI
- 1013237353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Social Worker 1041S0200X
- License
- 076492-1 (NY)
- Practice address
- 372 Grand Ave
7A
Leonia, NJ 07605-2256 - Phone
- (201) 920-5015
- NPI assigned
- Jun 9, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05242700 | NJ | MD | Social Worker |
| 076492-1 | NY | MD | School Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 076492-1 | NY | Yes |
| Social Worker | 104100000X | 44SL05242700 | NJ |
Addresses
Primary practice location
372 Grand Ave
7A
Leonia, NJ 07605-2256
Mailing address
372 Grand Ave
7A
Leonia, NJ 07605-2256
Phone (201) 920-5015
Other providers in Leonia, NJ
- Marsha K Ontell
- Orthopt of NJ
- Orthopt of NJ
- Palisades Optometrics LLC
- Jinha Park
- Paul Steven Poretzky
- Quality Home Care Providers, Inc.
- Laura L. Raucci
- Richard Joo MD Internal Medicine PC
- Royal Physical Therapy P.C.
All providers in Leonia, NJ · School Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.