Provider Demographics
NPI:1831637180
Name:PARK, HEE K (LCSW-C)
Entity Type:Individual
Prefix:
First Name:HEE
Middle Name:K
Last Name:PARK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15422 MANOR HOUSE TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1819
Mailing Address - Country:US
Mailing Address - Phone:412-915-1969
Mailing Address - Fax:
Practice Address - Street 1:15422 MANOR HOUSE TER
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853
Practice Address - Country:US
Practice Address - Phone:412-915-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical