Provider Demographics
NPI:1063814325
Name:CHEN, YILIN (LMSW)
Entity Type:Individual
Prefix:
First Name:YILIN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 212TH ST
Mailing Address - Street 2:APT 3A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2845
Mailing Address - Country:US
Mailing Address - Phone:917-648-6269
Mailing Address - Fax:
Practice Address - Street 1:4234 212TH ST
Practice Address - Street 2:APT 3A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2845
Practice Address - Country:US
Practice Address - Phone:917-648-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health