Provider Demographics
NPI:1225367287
Name:YEH, MAN-CHING MANDY (PHD, LCSW, LPC, LADC)
Entity Type:Individual
Prefix:
First Name:MAN-CHING
Middle Name:MANDY
Last Name:YEH
Suffix:
Gender:F
Credentials:PHD, LCSW, LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 THOMASTON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1007
Mailing Address - Country:US
Mailing Address - Phone:203-805-5413
Mailing Address - Fax:203-805-5312
Practice Address - Street 1:95 THOMASTON AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1007
Practice Address - Country:US
Practice Address - Phone:203-805-5413
Practice Address - Fax:203-805-5312
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000686101YA0400X
CT000938101YP2500X
CT0072101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional