Provider Demographics
NPI:1679530927
Name:HO, YUEN LING ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:YUEN LING
Middle Name:ELAINE
Last Name:HO
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 1:105 RAILY COURT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312
Mailing Address - Country:US
Mailing Address - Phone:718-605-3701
Mailing Address - Fax:
Practice Address - Street 1:227 MADISON STREET
Practice Address - Street 2:RM 329 GOUVERNEUR HEALTHCARE SERVICES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002
Practice Address - Country:US
Practice Address - Phone:212-238-7369
Practice Address - Fax:218-238-7399
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0700281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P39035Medicare UPIN
NY4661Medicare ID - Type Unspecified