Provider Demographics
NPI:1346758646
Name:YU, XINRAN (LCSW)
Entity Type:Individual
Prefix:
First Name:XINRAN
Middle Name:
Last Name:YU
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 1:1971 WESTERN AVE # 245
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5066
Mailing Address - Country:US
Mailing Address - Phone:518-245-6866
Mailing Address - Fax:
Practice Address - Street 1:14 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:VOORHEESVILLE
Practice Address - State:NY
Practice Address - Zip Code:12186-9649
Practice Address - Country:US
Practice Address - Phone:217-778-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-20
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1226591041C0700X
IL149.019301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health