Provider Demographics
NPI:1295272870
Name:CHEN, JING YI (MED, LPC, LPCC)
Entity type:Individual
Prefix:
First Name:JING YI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MED, LPC, LPCC
Other - Prefix:
Other - First Name:JING-YI
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1750 LUNDY AVE # 611533
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95101-9001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:907 WEST ST # 218
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2838
Practice Address - Country:US
Practice Address - Phone:650-200-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional