Chae W Kwak, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12156 Issued in MD

Practice address

711 W 40TH St
Suite 230B
Baltimore, MD 21211-2120

Phone

(410) 532-3080

Fax

(410) 532-3080

NPI assigned

Sep 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Ties of Brunswick, LLC

  • Professional Counselor
  • Wilmington, NC
  • NPI 1831682665

  Clinical

  Medicare reassignment NPD
• East Coast Rehab Partners, PLLC

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1356915797
  NPD (past)

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1174773246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 230B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112120",
            "telephone_number": "410-532-3080",
            "fax_number": "410-532-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 230B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112120",
            "telephone_number": "410-532-3080",
            "fax_number": "410-532-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "CHAE",
        "middle_name": "W",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Kvarta, MD, PHD
• Charlotte Louise Kvasnovsky, MD, MPH
• Karan S. Kverno, PMH NP
• Agnes Kwak, MD
• Cecilia Kwak
• Daniel Kwak
• Kee Hyun Kwak, DDS
• Lily Kwak
• Lina Kwak
• Minhie Willow Kwak, MD

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.