Provider Demographics
NPI:1609030949
Name:THE CHILD CENTER OF NY
Entity Type:Organization
Organization Name:THE CHILD CENTER OF NY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNG MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-358-8288
Mailing Address - Street 1:140-15B SANFORD AVE.
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2557
Mailing Address - Country:US
Mailing Address - Phone:718-358-8288
Mailing Address - Fax:718-358-5265
Practice Address - Street 1:140-15B SANFORD AVE.
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2557
Practice Address - Country:US
Practice Address - Phone:718-358-8288
Practice Address - Fax:718-358-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111733454251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health