Individual provider Active NPI

Ji Ye Kim

  • Social Worker
  • Ridgewood, NJ
National Provider Identifier
1508659590
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL07258100 Issued in NJ
Practice address
169 Dayton St Unit 7
Ridgewood, NJ 07450-4407
Phone
(201) 331-9291
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL07258100 NJ Primary

Addresses

Primary practice location

169 Dayton St Unit 7
Ridgewood, NJ 07450-4407

Mailing address

169 Dayton St Unit 7
Ridgewood, NJ 07450-4407
Phone (201) 331-9291

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
44SL07258100NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1508659590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 DAYTON ST UNIT 7",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504407",
            "telephone_number": "201-331-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 DAYTON ST UNIT 7",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504407",
            "telephone_number": "201-331-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI YE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL07258100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.