Provider Demographics
NPI:1508564402
Name:LE, CHINH THANH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHINH
Middle Name:THANH
Last Name:LE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 UNIVERSITY WAY NE STE 104
Mailing Address - Street 2:#5067
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:509-460-3672
Mailing Address - Fax:
Practice Address - Street 1:CARRERA 4, 79-25
Practice Address - Street 2:#801
Practice Address - City:BOGOTA
Practice Address - State:CUNDINAMARCA
Practice Address - Zip Code:110221
Practice Address - Country:CO
Practice Address - Phone:509-460-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW323921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical