Provider Demographics
NPI:1912155714
Name:CHAN, KAMSE SUK (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAMSE
Middle Name:SUK
Last Name:CHAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ARMOUR PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-4001
Mailing Address - Country:US
Mailing Address - Phone:347-782-1791
Mailing Address - Fax:718-608-1964
Practice Address - Street 1:31 ARMOUR PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-4001
Practice Address - Country:US
Practice Address - Phone:347-782-1791
Practice Address - Fax:718-608-1964
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061427-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker