Provider Demographics
NPI:1780831826
Name:BAEK, MARIE HYUNKYUNG (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:HYUNKYUNG
Last Name:BAEK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147-45 BARCLAY AVE.
Mailing Address - Street 2:#4D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:213-246-9545
Mailing Address - Fax:
Practice Address - Street 1:14745 BARCLAY AVE APT 4D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1263
Practice Address - Country:US
Practice Address - Phone:213-249-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical