Sowoon Park, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094002 Issued in NY

Practice address

397 Bridge St
Brooklyn, NY 11201-5292

Phone

(917) 524-8621

NPI assigned

Feb 12, 2020

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• Marbled Mind, LCSW PLLC

  • Adult Mental Health Clinic/Center
  • Brooklyn, NY
  • NPI 1730999871
  NPD Authorized official

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1669004180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CANTERBURY RD APT 2H",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212134",
            "telephone_number": "917-524-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 BRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015292",
            "telephone_number": "917-524-8621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "178 E 85th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100282119",
            "country_code": "US",
            "telephone_number": "212-434-6776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Canterbury Rd Apt 2H",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110212134",
            "country_code": "US",
            "telephone_number": "917-524-8621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOWOON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliver Park, MD
• Rosa Park, MD
• Sai Chang Park, M.D.
• Sejin Park, NP
• Seungman Park, L.AC.
• Sun Hyee Park, PHARMD
• Tae K Park, M.D.
• William Park
• Youngjun Park, MD
• Youngsun Park

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 Jan 10, 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.