MISS NAKYUNG IM LICSWLADC1IABMCP NPI 1962530790

NPI Information

  • NPI: 1962530790
  • Provider Name: MISS NAKYUNG IM, LICSW,,LADC1,IABMCP
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 308A HARVARD ST
    #2
    BROOKLINE, MA
    ZIP 02446
  • Phone: (617) 738-9622

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NPI Details

MISS Nakyung Im, LICSW,,LADC1,IABMCP is a clinical social worker in Brookline, MA with 54 years of experience. 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. MISS Nakyung Im, LICSW,,LADC1,IABMCP NPI is 1962530790. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

308A HARVARD ST
#2
BROOKLINE, MA
ZIP 02446-900
Phone: (617) 738-9622
Fax: (617) 738-9623

The NPI 1962530790 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 3/1/2007 and was last updated on 7/9/2007.

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
11041C0700XSocial WorkerClinical103115MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1249058OTHERMASSACHUSETTSTRICARE
2724940OTHERMASSACHUSETTSTUFTS HEALTH PLAN
3P03698OTHERMASSACHUSETTSBLUECROSSBLUESHIELD
462-03541OTHERMASSACHUSETTSUNITED BEHAVIOR HEALTH
52040351OTHERMASSACHUSETTSCIGNA HEALTH
64504465OTHERMASSACHUSETTSAETNA HEALTH CARE
7P03698MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
8S024286OTHERMASSACHUSETTSCHAMPUS
9831200OTHERMASSACHUSETTSFIRST HEALTH GROUP CORP.
10239881OTHERMASSACHUSETTSPRIVATE HEALTH CARE SYSTE
11012700OTHERMASSACHUSETTSVALUEOPTIONS
12724940OTHERMASSACHUSETTSSECURE HORIZON
131858572MEDICAIDMASSACHUSETTS
141898256MEDICAIDMASSACHUSETTS

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: 3/30/2025

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