Individual provider Active NPI

NA Gyeong Lee, ACSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1205650082
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ACSW133835 Issued in CA
Practice address
1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone
(213) 483-3000
Fax
(213) 483-6529
NPI assigned
Nov 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ACSW133835 CA Primary
Day Training/Habilitation Specialist 373H00000X CA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1310 Wilshire Blvd
Los Angeles, CA 90017-1705

Mailing address

1310 Wilshire Blvd
Los Angeles, CA 90017-1705
Phone (213) 483-3000

Other practice location 1

1453 W Temple St
Los Angeles, CA 90026-5648
Phone (213) 202-3970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ACSW133835CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1205650082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000",
            "fax_number": "213-483-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171705",
            "telephone_number": "213-483-3000",
            "fax_number": "213-483-6529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1453 W Temple St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900265648",
            "country_code": "US",
            "telephone_number": "213-202-3970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "NA GYEONG",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-08",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ACSW133835",
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.