Provider Demographics
NPI:1922530641
Name:LIN, CHIH-HSIEN (LCPC, BC-DMT, EMDR)
Entity Type:Individual
Prefix:
First Name:CHIH-HSIEN
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:LCPC, BC-DMT, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 W NORWOOD ST
Mailing Address - Street 2:APT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-2592
Mailing Address - Country:US
Mailing Address - Phone:312-608-2999
Mailing Address - Fax:
Practice Address - Street 1:1215 W NORWOOD ST
Practice Address - Street 2:APT 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-2592
Practice Address - Country:US
Practice Address - Phone:312-608-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBC-DMT-1288225600000X
IL180.011985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
13987434OtherCAQH