Provider Demographics
NPI:1407536782
Name:DR. CHEN PSYCHOLOGICAL SERVICE
Entity Type:Organization
Organization Name:DR. CHEN PSYCHOLOGICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-747-0157
Mailing Address - Street 1:4310 CRESCENT ST APT 1703
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4257
Mailing Address - Country:US
Mailing Address - Phone:646-820-6515
Mailing Address - Fax:
Practice Address - Street 1:4310 CRESCENT ST APT 1703
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4257
Practice Address - Country:US
Practice Address - Phone:646-820-6515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty