Provider Demographics
NPI:1760882559
Name:FLUSHING CHINESE COUNSELING LICENSED CLINICAL SOCIAL WORK, P.C.
Entity Type:Organization
Organization Name:FLUSHING CHINESE COUNSELING LICENSED CLINICAL SOCIAL WORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:XUEJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-267-6885
Mailing Address - Street 1:6130 157TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1241
Mailing Address - Country:US
Mailing Address - Phone:646-267-6885
Mailing Address - Fax:718-888-0225
Practice Address - Street 1:6130 157TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1241
Practice Address - Country:US
Practice Address - Phone:646-267-6885
Practice Address - Fax:718-888-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11714101YA0400X
NY0797551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty