Provider Demographics
NPI:1740690304
Name:CHIANG, KEVIN (LCSW)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06120-2901
Mailing Address - Country:US
Mailing Address - Phone:860-761-7922
Mailing Address - Fax:860-761-7928
Practice Address - Street 1:330 MARKET ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-2901
Practice Address - Country:US
Practice Address - Phone:860-761-7922
Practice Address - Fax:860-761-7928
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical