Active NPI
Kristelle Myung Kwak-Reid, LCSW
- Clinical Social Worker
- Van Nuys, CA
National Provider Identifier
1912202235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27002
- Practice address
- 6551 Van Nuys Blvd
Suite 201
Van Nuys, CA 91401-1442 - Phone
- (818) 988-6335
- Fax
- (818) 988-6817
- NPI assigned
- Jan 18, 2011
- Last updated
- Jan 18, 2011
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27002 | CA | Primary |
Addresses
Primary practice location
6551 Van Nuys Blvd
Suite 201
Van Nuys, CA 91401-1442
Mailing address
12810 Woodley Avenue
Granada Hills, CA 91344
Phone (562) 301-5262
Other names 1
- Kris, Myung Hee Kwak-Reid
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Valley Health Corporation | Past | Accepting new patients | |
| Northeast Valley Health Corporation | 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.
-
dba SCV Dental and Wellness Center
- Federally Qualified Health Center (FQHC)
- Santa Clarita, CA
- NPI 1548960834
-
dba Van Nuys Adult Health Center
- Federally Qualified Health Center (FQHC)
- Van Nuys, CA
- NPI 1629079009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1912202235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12810 WOODLEY AVENUE",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "91344",
"telephone_number": "562-301-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6551 VAN NUYS BLVD",
"address_2": "SUITE 201",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914011442",
"telephone_number": "818-988-6335",
"fax_number": "818-988-6817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAK-REID",
"first_name": "KRISTELLE",
"middle_name": "MYUNG",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-18",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "27002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRIS, MYUNG",
"last_name": "KWAK-REID",
"middle_name": "HEE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.