Meeock Park, PH. D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1838 Issued in MN

Practice address

2920 Talmage Ave SE
Minneapolis, MN 55414-2780

Phone

(612) 272-9752

Fax

(612) 342-1341

NPI assigned

Nov 4, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Korean Service Center

  • Home Health Agency
  • Minneapolis, MN
  • NPI 1669601423
  NPD (past)

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1962703124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 CEDAR AVE. S. #B-1",
            "address_2": "ATTN: MEEOCK PARK",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-272-9752",
            "fax_number": "612-342-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 TALMAGE AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142780",
            "telephone_number": "612-272-9752",
            "fax_number": "612-342-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MEEOCK",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glennon Kyusun Park, M.D.
• Jeong Eun Park, LMFT
• June Park, PA-C
• Kaila Park, LPCC
• Katharine Sippel Park, MD
• Michael Chankwon Park, M.D., PH.D.
• Paul Park
• Shannon Park
• Sue Young Park, M.D.
• Suhyun Park

• Marriage & Family Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.