Individual provider Active NPI

Elizabeth Sun Mee-Kim Ryu, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1952426512
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS29658 Issued in CA
Practice address
550 S Vermont Ave
Los Angeles, CA 90020
Phone
(213) 842-7003
NPI assigned
Mar 20, 2007
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS29658 CA Primary

Addresses

Primary practice location

550 S Vermont Ave
Los Angeles, CA 90020

Mailing address

605 W Olympic Blvd Ste 550
Los Angeles, CA 90015-1474
Phone (213) 553-1850

Other identifiers 1

IdentifierTypeStateIssuer
95-6000927WMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20131025000743 CA Practitioner - Clinical Social Worker 9335374412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6 Centerpointe Dr
Suite 700
La Palma, CA 90623-2545
Phone (213) 331-7774

6281 Beach Blvd
Suite 304
Buena Park, CA 90621-4248
Phone (213) 331-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS29658CAMDClinical Social Worker
29658CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Well Mental Health Counseling Licensed Clinical Social Worker Inc CurrentSince Mar 1, 2025 Accepting new patients

Locations

6281 Beach Blvd
Ste 304
Buena Park, CA 90621
Phone (213) 331-7774

6 Centerpointe Dr
Ste 700
La Palma, CA 90623
Phone (213) 331-7774

Organizations & group practices 1

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1952426512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W OLYMPIC BLVD STE 550",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151474",
            "telephone_number": "213-553-1850",
            "fax_number": "213-553-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "213-842-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "ELIZABETH",
        "middle_name": "SUN MEE-KIM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS29658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-6000927W",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.