JENNY YEEUN PARK
NPI 1194544528
Counselor - Mental Health in Bethpage, NY

Q: What is Jenny Park's NPI number?

The NPI number for Jenny Park is 1194544528. It was assigned to this individual provider in the NPPES registry on October 3, 2024.

Q: What is Jenny Park's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Jenny Park enrolled in Medicare?

No. Jenny Park has opted out of Medicare through November 13, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jenny Park was last updated on October 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 03, 2024Opted out of Medicare · through Nov 13, 2026

1211 STEWART AVE STE 100, BETHPAGE, NY 11714(516) 465-3999 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jenny Yeeun Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNY YEEUN PARK (NPI 1194544528) is an individual mental health provider in Bethpage, New York, licensed in New York (015218) and active in the NPI registry since October 2024. She has opted out of Medicare through November 13, 2026.

NPPES Registry Identity

NPI1194544528

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJENNY YEEUN PARK

Location Address1211 STEWART AVE STE 100Bethpage, NY 11714-1601

Mailing Address1211 Stewart Ave Ste 100Bethpage, NY 11714-1601

Phone(516) 465-3999

Sole ProprietorNo

Enumeration DateOctober 3, 2024

NPPES CertifiedOctober 3, 2024

✔ NPI 1194544528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NY · 015218

1211 STEWART AVE STE 100, Bethpage, NY 11714

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Jenny Yeeun Park has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 13, 2024 through November 13, 2026.

Opt-Out Effective DateNovember 13, 2024

Opt-Out In Effect ThroughNovember 13, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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