Provider Demographics
NPI:1457674251
Name:CHANG-ARRATIA, CARMEN PAZ (LCSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:PAZ
Last Name:CHANG-ARRATIA
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 1:147 W 35TH ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2114
Mailing Address - Country:US
Mailing Address - Phone:646-522-0404
Mailing Address - Fax:267-851-4762
Practice Address - Street 1:147 W 35TH ST STE 1001
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2114
Practice Address - Country:US
Practice Address - Phone:646-522-0404
Practice Address - Fax:267-851-4762
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR078583-11041C0700X
NY078583-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03394103Medicaid
NYA300114353Medicare PIN