Jee Sook Park, MA, M.ED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6563 Edsall Rd
Springfield, VA 22151-4414

Phone

(703) 408-2805

Fax

(703) 354-1129

NPI assigned

Dec 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Arts

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.

• Multicultural Clinical Center

  • Community/Behavioral Health Agency
  • Springfield, VA
  • NPI 1487989471
  NPD (past)
• Multicultural Clinical Center

  • Counselor
  • Springfield, VA
  • NPI 1952360612
  NPD (past)

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1568934784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6563 EDSALL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514414",
            "telephone_number": "703-408-2805",
            "fax_number": "703-354-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6563 EDSALL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514414",
            "telephone_number": "703-408-2805",
            "fax_number": "703-354-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEE SOOK",
        "credential": "MA, M.ED, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Palencia, RBT
• Pamir Healthcare Services, LLC
• Dimitrios Constantinos Papadouris, M.D.
• Edward S. Parelhoff, M.D.
• Cynthia Park, DDS
• Jennifer Park, M.D.
• Jinsil Park
• Natalie Park
• Sor Bi Park, DDS
• Allison C Parker, OTR

• Behavior Analyst in Springfield, VA
• Providers in Springfield, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.