Individual provider Active NPI

Yeong J Bae, LCSW, M.DIV

  • Clinical Social Worker
  • Fort Washington, PA
National Provider Identifier
1902624596
Registry record updated Sep 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW027982 Issued in PA
Practice address
390 Commerce Dr
Fort Washington, PA 19034-2600
Phone
(267) 337-8213
Fax
(833) 367-0993
NPI assigned
Oct 1, 2024
Last updated
Sep 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CW027982 PA Primary

Addresses

Primary practice location

390 Commerce Dr
Fort Washington, PA 19034-2600

Mailing address

2003 Ballantine LN
Warrington, PA 18976-2738
Phone (610) 937-5615

Other practice location 1

2003 Ballantine Ln
Warrington, PA 18976-2738
Phone (610) 937-5615

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

State licenses

LicenseStateTypeSpecialty
CW027982PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie of Bucks LLC Multi-Specialty Past Accepting new patients

Organizations & group practices 2

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1902624596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 BALLANTINE LN",
            "city": "WARRINGTON",
            "state": "PA",
            "postal_code": "189762738",
            "telephone_number": "610-937-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 COMMERCE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342600",
            "telephone_number": "267-337-8213",
            "fax_number": "833-367-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Ballantine Ln",
            "address_purpose": "LOCATION",
            "city": "Warrington",
            "state": "PA",
            "postal_code": "189762738",
            "country_code": "US",
            "telephone_number": "610-937-5615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAE",
        "first_name": "YEONG",
        "middle_name": "J",
        "credential": "LCSW, M.DIV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-01",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW027982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.