Provider Demographics
NPI:1912914508
Name:AJJAN, CHAMIN (LCSW, ACT)
Entity Type:Individual
Prefix:MRS
First Name:CHAMIN
Middle Name:
Last Name:AJJAN
Suffix:
Gender:F
Credentials:LCSW, ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST
Mailing Address - Street 2:SUITE 1303
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-0103
Mailing Address - Country:US
Mailing Address - Phone:917-476-9381
Mailing Address - Fax:718-789-1207
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 1303
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:917-476-9381
Practice Address - Fax:718-789-1207
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071146-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical