Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sung Jae Shin, LCSW

Individual provider Social Worker · NPI 1710575568

Sung Jae Shin, LCSW is a Clinical Social Worker in Rego Park, New York. Qualified in 2013, 13 years ago. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2021
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

6110 Alderton St Apt B3
Rego Park, NY 11374-2702
Phone: (929) 206-7720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 097784 (NY)
Social Worker Taxonomy 104100000X · Licence 091861 (NY)

Record details

NPI number1710575568
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 7, 2021
Last updated in NPPESJune 7, 2024
Certification dateJune 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Not indicated

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