Active NPI
In Sook Park, M.D.
- Child & Adolescent Psychiatry Physician
- Frederick, MD
National Provider Identifier
1881683571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- D0042130
- Practice address
- 350 Montevue LN
Frederick, MD 21702-8214 - Phone
- (301) 694-1029
- Fax
- (301) 631-5111
- NPI assigned
- Oct 17, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | D0042130 | MD | Primary |
Addresses
Primary practice location
350 Montevue LN
Frederick, MD 21702-8214
Mailing address
350 Montevue LN
Frederick, MD 21702-8214
Phone (301) 694-1029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0042130 | MD | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1881683571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 MONTEVUE LN",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217028214",
"telephone_number": "301-694-1029",
"fax_number": "301-631-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 MONTEVUE LN",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217028214",
"telephone_number": "301-694-1029",
"fax_number": "301-631-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "IN",
"middle_name": "SOOK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MD",
"license": "D0042130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.