Individual provider Active NPI

Joonjoa Park, LCSW

  • Clinical Social Worker
  • Flushing, NY
National Provider Identifier
1912501347
Registry record updated Apr 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101088 Issued in NY
Practice address
13626 37TH Ave
Flushing, NY 11354-6533
Phone
(718) 886-7373
Fax
(718) 661-6035
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 101088 NY Primary
Social Worker 104100000X 110291 NY

Addresses

Primary practice location

13626 37TH Ave
Flushing, NY 11354-6533

Mailing address

125 Walker St FL 2
New York, NY 10013-4135
Phone (212) 226-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20251024001899 NY Practitioner - Clinical Social Worker 9931697430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

487 S Broadway
Yonkers, NY 10705-3269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110291NYMDSocial Worker
101088NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Jewish Community Services Inc. CurrentSince Sep 26, 2025 Accepting new patients
Charles B. Wang Community Health Center, Inc. Past Accepting new patients

Locations

141 N Central Ave
Hartsdale, NY 10530
Phone (914) 949-6761

845 N Broadway
White Plains, NY 10603

487 S Broadway
Yonkers, NY 10705
Phone 914423443315

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1912501347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13626 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546533",
            "telephone_number": "718-886-7373",
            "fax_number": "718-661-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOONJOA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101088",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "110291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.