Provider Demographics
NPI:1801261342
Name:CHENG, JACQUELINE (CASAC-T)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PEARCE PL
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3239
Mailing Address - Country:US
Mailing Address - Phone:516-790-5038
Mailing Address - Fax:
Practice Address - Street 1:8 PEARCE PL
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3239
Practice Address - Country:US
Practice Address - Phone:516-790-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)