Active NPI
Jahyang Koo Kim, LMSW
- Social Worker
- Flushing, NY
National Provider Identifier
1912144437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 076140
- Practice address
- 140-15B Sanford Ave, 2ND Floor
Flushing, NY 11355 - Phone
- (718) 358-8288
- Fax
- (718) 358-5265
- NPI assigned
- Jan 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 076140 | NY | Primary |
| Social Worker | 104100000X | 44SL05497600 | NJ |
Addresses
Primary practice location
140-15B Sanford Ave, 2ND Floor
Flushing, NY 11355
Mailing address
194 Webster Rd
Scarsdale, NY 10583-5932
Phone (914) 262-6943
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05497600 | NJ | MD | Social Worker |
| 076140 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1912144437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "194 WEBSTER RD",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105835932",
"telephone_number": "914-262-6943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140-15B SANFORD AVE, 2ND FLOOR",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11355",
"telephone_number": "718-358-8288",
"fax_number": "718-358-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAHYANG",
"middle_name": "KOO",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "076140",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05497600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.