Active NPI
Jee-Eun Jenny Moon, LCSW
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1114353455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 77266
- Practice address
- 4510 E Pacific Coast Hwy
Suite 600
Long Beach, CA 90804-3279 - Phone
- (562) 346-1143
- NPI assigned
- Sep 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 77266 | CA | Primary |
Addresses
Primary practice location
4510 E Pacific Coast Hwy
Suite 600
Long Beach, CA 90804-3279
Mailing address
4510 E Pacific Coast Hwy
Suite 600
Long Beach, CA 90804-6914
Phone (562) 346-1143
Other practice location 1
3838 W Carson St Ste 330
Torrance, CA 90503-6710
Phone (424) 262-1761
Other names 1
- Jenny Moon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 25, 2023 through Dec 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1114353455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4510 E PACIFIC COAST HWY",
"address_2": "SUITE 600",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908046914",
"telephone_number": "562-346-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4510 E PACIFIC COAST HWY",
"address_2": "SUITE 600",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908043279",
"telephone_number": "562-346-1143"
}
],
"practiceLocations": [
{
"address_1": "3838 W Carson St Ste 330",
"address_purpose": "LOCATION",
"city": "Torrance",
"state": "CA",
"postal_code": "905036710",
"country_code": "US",
"telephone_number": "424-262-1761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOON",
"first_name": "JEE-EUN",
"middle_name": "JENNY",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "77266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNY",
"last_name": "MOON",
"credential": "LCSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.