Min Kyoung Park Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06567100 Issued in NJ

Practice address

130 W Kingsbridge Rd
Bronx, NY 10468-3904

Phone

(551) 424-4788

NPI assigned

Oct 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Glowmind Counseling LLC

  • Community/Behavioral Health Agency
  • Fort Lee, NJ
  • NPI 1003796723
  NPD Authorized official

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1427820398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 MAPLE ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242535",
            "telephone_number": "551-424-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "551-424-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1658 Maple St",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "NJ",
            "postal_code": "070242535",
            "country_code": "US",
            "telephone_number": "719-440-4775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIN KYOUNG",
        "middle_name": "PARK",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06567100",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06663300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100810",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Johnson
• Matthew Alan Johnson, MD
• Megan Elizabeth Yanique Johnson, MBBS
• Michelle Johnson
• Mildred Johnson
• Mitchell Edward Johnson Jr., CASAC
• Monica D Johnson
• Nacia Johnson
• Naimah Efia Johnson, LMSW
• Nancy Johnson

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.