Provider Demographics
NPI:1992291744
Name:PARK, HELEN HYUN-KYUNG (LMSW)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:HYUN-KYUNG
Last Name:PARK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3968 45TH ST # 2F
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2104
Mailing Address - Country:US
Mailing Address - Phone:917-374-9209
Mailing Address - Fax:
Practice Address - Street 1:936 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8104
Practice Address - Country:US
Practice Address - Phone:212-879-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100675-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical