Joann Park, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

073998-1 Issued in NY

Practice address

65 Columbus Ave
Staten Island, NY 10304-4325

Phone

(718) 448-3210

Fax

(718) 984-2642

NPI assigned

Jun 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• True North Medical Group PC

  dba Orlin & Cohen Medical Specialists Group

  • Orthopaedic Surgery Physician
  • Merrick, NY
  • NPI 1659883486
  NPD
• True North Medical Group PC

  dba Orlin and Cohen Medical Specialist Group

  • Oxygen Equipment & Supplies (DME)
  • Tarrytown, NY
  • NPI 1669272886
  NPD

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1619103595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091207",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 COLUMBUS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044325",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "073998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073998-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Dermatology, PC
• Park Slope Comprehensive Medical Wellness PLLC
• Catherine Y Park, MD
• Innjea Park, DPM
• Jane NA Park, DO
• Milae Park, APN, WHNP-BC
• Andrea M. Parker, MA CCC-SLP
• Tracy Parker
• Lauren Elizabeth Parks
• Zarina Parnas, PHARM.D

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, 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 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.