Individual provider Active NPI

Min Soo Son

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1083968002
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108
Phone
(213) 637-1080
Fax
(213) 637-1075
NPI assigned
Oct 29, 2012
Reactivated
Sep 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA Primary

Addresses

Primary practice location

3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108

Mailing address

2410 W Orangethorpe Ave Apt 3
Fullerton, CA 92833-4260
Phone (310) 658-2763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260217003077 GA Practitioner - Clinical Social Worker 6103306212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carenow Services, LLCGroup PAC ID 2163561259, 36 clinicians

Practice addresses (Care Compare)

401 Bombay LN
Roswell, GA 30076-5826
Phone (770) 664-1920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carenow Services, LLC CurrentSince Feb 9, 2026 Accepting new patients

Locations

401 Bombay Ln
Roswell, GA 30076
Phone (770) 664-1920

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.

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1083968002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 W ORANGETHORPE AVE APT 3",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334260",
            "telephone_number": "310-658-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 W 6TH ST STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205108",
            "telephone_number": "213-637-1080",
            "fax_number": "213-637-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "MIN SOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-29",
        "last_updated": "2025-09-25",
        "deactivation_date": "2025-08-27",
        "reactivation_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.