Jina Park, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06280800 Issued in NJ

Practice address

121 Newark Ave Ste 410
Jersey City, NJ 07302-5873

Phone

(201) 677-2232

NPI assigned

Oct 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jina Park, LCSW LLC

  dba Rise Psychotherapy

  • Clinical Social Worker
  • Tenafly, NJ
  • NPI 1003665282
  NPD Authorized official

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1942776133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MONROE AVE",
            "city": "CRESSKILL",
            "state": "NJ",
            "postal_code": "076261438",
            "telephone_number": "562-708-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 NEWARK AVE STE 410",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025873",
            "telephone_number": "201-677-2232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "247 Prospect Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112158403",
            "country_code": "US",
            "telephone_number": "646-685-4499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098215-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06280800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Eunhee Park, DACM, LAC
• Eunbi Park
• Gyu Tae Park, D.D.S.
• Hyojin Park
• Isaac Park
• Jung Ho Park
• Min Park
• Seongae Park
• Soyoung Park
• Toni Park, PHARMD, RPH

• Clinical Social Worker in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.