Ji-Hae Park, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0903001428 Issued in VA

Practice address

6245 Leesburg Pike
4TH Floor - Outreach
Falls Church, VA 22044-2106

Phone

(703) 531-6283

NPI assigned

Jan 9, 2007

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 DC

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Director of Finance-County of Fairfax VAGroup PAC ID 9739136847, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Fairfax County, Virginia

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740339076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 PARK CENTER DR",
            "address_2": "APT. #A909",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021431",
            "telephone_number": "703-379-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 LEESBURG PIKE",
            "address_2": "4TH FLOOR - OUTREACH",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442106",
            "telephone_number": "703-531-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JI-HAE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0903001428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Medical Group, P.C.
• Esther Park, DDS
• Esther Min Park
• Hannah Ariel Hyein Park
• Hannah Jiyoon Park
• Jinny Park
• Ju Ae Park, MD
• Leah Park
• Rachel Sohyung Park, M.D.
• Ryan Park, MD

• Social Worker in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.