Provider Demographics
NPI:1326849191
Name:CHEN, KAIWEN
Entity type:Individual
Prefix:MR
First Name:KAIWEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:
Credentials:
Other - Prefix:MR
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1234 BROADWAY STE 6
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 HOPE AVE STE 107
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2717
Practice Address - Country:US
Practice Address - Phone:617-390-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health