Individual provider Active NPI

Joy Jeongah Yang, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1558569376
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW29177 Issued in CA
Practice address
550 S Vermont Ave
Los Angeles, CA 90020-1912
Phone
(213) 639-6777
Fax
(213) 637-0790
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW29177 CA Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

550 S Vermont Ave
Los Angeles, CA 90020-1912

Mailing address

1665 W Adams Blvd
Los Angeles, CA 90007-1533
Phone (323) 731-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131031001296 CA Practitioner - Clinical Social Worker 1759516677 Reassigns benefits to 1 organization
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW29177CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Well Mental Health Counseling Licensed Clinical Social Worker Inc CurrentSince Mar 27, 2024 Accepting new patients

Locations

6281 Beach Blvd
Ste 304
Buena Park, CA 90621
Phone (213) 331-7774

6 Centerpointe Dr
Ste 700
La Palma, CA 90623
Phone (213) 331-7774

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1558569376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 W ADAMS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900071533",
            "telephone_number": "323-731-3534",
            "fax_number": "323-731-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912",
            "telephone_number": "213-639-6777",
            "fax_number": "213-637-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JOY",
        "middle_name": "JEONGAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LSW29177",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.