Provider Demographics
NPI:1346443108
Name:HUANG, HEATHER JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JEAN
Last Name:HUANG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15517 SANFORD AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1157
Mailing Address - Country:US
Mailing Address - Phone:718-353-7633
Mailing Address - Fax:
Practice Address - Street 1:4119 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-3007
Practice Address - Country:US
Practice Address - Phone:718-652-0227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73-0741761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY73-074176OtherLCSW