Elly Yooil Jeong, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CSW008625 Issued in GA

Practice address

1730 Westfield CT
Lawrenceville, GA 30043-5664

Phone

(212) 401-2206

NPI assigned

Apr 24, 2023

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

Enrolled in GA

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Talk to Heal Counseling Center LLC

  • Clinical Social Worker
  • Johns Creek, GA
  • NPI 1396543260
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1669169231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 WESTFIELD CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435664",
            "telephone_number": "212-401-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 WESTFIELD CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435664",
            "telephone_number": "212-401-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "ELLY",
        "middle_name": "YOOIL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW008625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer McCoy DDS Lawrenceville, LLC
• Crystal Jennings
• Phillip Jennings III
• Philip Jenny
• Kevin Lee Jensen, M.D.
• Jeremiah Counseling LLC
• Phara Jerome
• Jerry E Nutt DDS & Assoc of Lawrenceville
• Doris Dean Jeter
• Tulsi Jetha, FNP-BC

• Mental Health Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.