Provider Demographics
NPI:1669709754
Name:SHINN, HEEJIN (LCSW)
Entity type:Individual
Prefix:
First Name:HEEJIN
Middle Name:
Last Name:SHINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEEJIN
Other - Middle Name:
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-0912
Mailing Address - Country:US
Mailing Address - Phone:818-383-7177
Mailing Address - Fax:
Practice Address - Street 1:255 S GLENDORA AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-7222
Practice Address - Country:US
Practice Address - Phone:818-383-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA989301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical