Suzanne I. Park, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-4755 Issued in HI

Practice address

1109 12TH Ave Ste 201
Honolulu, HI 96816-3714

Phone

(831) 350-0109

NPI assigned

Sep 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1205355807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 12TH AVE STE 201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163714",
            "telephone_number": "831-305-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 12TH AVE STE 201",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968163714",
            "telephone_number": "831-350-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUZANNE",
        "middle_name": "I.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101643",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "HI",
            "license": "LSW-2562",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-4755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Park, APRN
• Philip Duheung Park, DDS
• Sarah Y. Park, M.D.
• Sharon Park, MD
• Stefanie Midori Park, MD
• Taryn Park, MD
• Thomas Park, MD
• Yank Sook Park, RN
• Young Cha Park, M.D.
• Young Jae Park, PHARMD

• Clinical Social Worker in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.