Individual provider Active NPI

Youngjae Lee, LCSW

  • Clinical Social Worker
  • Fort Lee, NJ
National Provider Identifier
1215566799
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05757800 Issued in NJ
Practice address
2185 Lemoine Ave
Unit 1C
Fort Lee, NJ 07024-6030
Phone
(877) 959-8180
Fax
(866) 535-3188
NPI assigned
Apr 6, 2020
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05757800 NJ Primary

Addresses

Primary practice location

2185 Lemoine Ave
Unit 1C
Fort Lee, NJ 07024-6030

Mailing address

2185 Lemoine Ave
Unit 1C
Fort Lee, NJ 07024-6030
Phone (877) 959-8180

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05757800NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1215566799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "UNIT 1C",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "877-959-8180",
            "fax_number": "866-535-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "UNIT 1C",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "877-959-8180",
            "fax_number": "866-535-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOUNGJAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05757800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.