Provider Demographics
NPI:1437319043
Name:JIN, YAN (MA, MS)
Entity Type:Individual
Prefix:MS
First Name:YAN
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MAJOR KING LN
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4797
Mailing Address - Country:US
Mailing Address - Phone:301-567-3959
Mailing Address - Fax:301-567-3959
Practice Address - Street 1:312 MAJOR KING LN
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4797
Practice Address - Country:US
Practice Address - Phone:301-567-3959
Practice Address - Fax:301-567-3959
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-03-1177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health