Provider Demographics
NPI:1942658216
Name:CHANG, JEFFREY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:CHANG
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 1:225 RIVER RD
Mailing Address - Street 2:APT F46
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1266
Mailing Address - Country:US
Mailing Address - Phone:551-404-0254
Mailing Address - Fax:
Practice Address - Street 1:79 E POST RD
Practice Address - Street 2:FL 3
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5008
Practice Address - Country:US
Practice Address - Phone:914-286-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0896201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical