Nancy Shin-Yii Jung, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004809 Issued in CT

Practice address

5105 SW Westchester Rd
Bentonville, AR 72712-7727

Phone

(479) 715-6739

NPI assigned

Feb 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/ccaoh/r4/

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.

• Catholic Charities, Inc. - Archdiocese of Hartford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milford, CT
  • NPI 1124112347
  NPD (past)
• Catholic Charities, Inc. - Archdioceseof Hartford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meriden, CT
  • NPI 1578657789
  NPD (past)
• Southern CT Christian Network

  dba Shoreline Christian Counseling

  • Forensic Psychiatry Physician
  • Madison, CT
  • NPI 1033239249

  Clinical

  NPD (past)

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1174667596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 SW WESTCHESTER RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127727",
            "telephone_number": "479-715-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 SW WESTCHESTER RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127727",
            "telephone_number": "479-715-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "NANCY",
        "middle_name": "SHIN-YII",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET-MHN",
            "identifier": "307875",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Jordan, OT
• Joseph Dik Chiropractic P.a. (Bentonville Chiropractic)
• Payton Journagan
• JRJ Family Enterprises LLC (Ozark Valley Chiropractic)
• Tuesday Julius Willis, MHPP
• Juniper Health PA
• Sylvia C Kabura
• Dana Kahl, PT, DPT
• Brianna Kaiser
• Kajsiab Therapy, PLLC

• Clinical Social Worker in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.