Active NPI
Laura Hyohyun Jin
- Social Worker
- Flushing, NY
National Provider Identifier
1053077917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 105462-01
- Practice address
- 42-16 162ND Street
2ND Floor
Flushing, NY 11358 - Phone
- (718) 366-9540
- NPI assigned
- Nov 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 105462-01 | Primary | |
| Social Worker | 104100000X | 105461-01 | NY |
Addresses
Primary practice location
42-16 162ND Street
2ND Floor
Flushing, NY 11358
Mailing address
42-16 162ND Street
2ND Floor
Flushing, NY 11358
Phone (718) 366-9540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105461-01 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Korean Community Services of Metropolitan New York, Inc. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Flushing, NY
- NPI 1942687868
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1053077917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42-16 162ND STREET",
"address_2": "2ND FLOOR",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11358",
"telephone_number": "718-366-9540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42-16 162ND STREET",
"address_2": "2ND FLOOR",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11358",
"telephone_number": "718-366-9540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIN",
"first_name": "LAURA",
"middle_name": "HYOHYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "105462-01",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "105461-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.