Individual provider Active NPI

Jonghyeok Lee

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1710444377
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1968 W Adams Blvd # 101
Los Angeles, CA 90018-3515
Phone
(323) 731-3534
NPI assigned
Mar 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 85457 CA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1968 W Adams Blvd # 101
Los Angeles, CA 90018-3515

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 CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230131002130 CA Practitioner - Clinical Social Worker 8820469729 Reassigns benefits to 2 organizations
Practice locations: La Palma, CA
I20231205001322 CA Practitioner - Clinical Social Worker 8820469729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6 Centerpointe Dr
La Palma, CA 90623-2545
Phone (213) 331-7774

6281 Beach Blvd
Buena Park, CA 90621-4248
Phone (213) 331-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Well Mental Health Counseling Licensed Clinical Social Worker Inc Mental Health CurrentSince Sep 16, 2023 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Dec 26, 2022 Accepting new patients
Lee and Kim Family Inc Clinical PastSince Dec 6, 2022 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

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1710444377",
    "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": "1968 W ADAMS BLVD # 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900183515",
            "telephone_number": "323-731-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONGHYEOK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-01",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "85457",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.