Provider Demographics
NPI:1689002107
Name:CHANG, MING (LMHC, LADC I)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:LMHC, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2888
Mailing Address - Country:US
Mailing Address - Phone:617-223-7021
Mailing Address - Fax:
Practice Address - Street 1:7 HARRIS AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2888
Practice Address - Country:US
Practice Address - Phone:617-223-7021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1025101YA0400X
MA4950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)