SUNG JAE SHIN LCSW NPI 1710575568

NPI Information

  • NPI: 1710575568
  • Provider Name: SUNG JAE SHIN, LCSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6110 ALDERTON ST APT B3
    REGO PARK, NY
    ZIP 11374
  • Phone: (929) 206-7720

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NPI Details

Sung Jae Shin, LCSW is a clinical social worker in Rego Park, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Sung Jae Shin, LCSW NPI is 1710575568. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6110 ALDERTON ST APT B3
REGO PARK, NY
ZIP 11374-702
Phone: (929) 206-7720

The NPI 1710575568 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 1/7/2021 and was last updated on 6/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker091861NEW YORKNo
21041C0700XSocial WorkerClinical097784NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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