Individual
CHEN CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14015B SANFORD AVE FL 2, FLUSHING, NY 11355-2557
(718) 358-8288
Mailing address
506 W 122ND ST APT 4, NEW YORK, NY 10027-5850
(929) 371-9805
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
102306-1
NY
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16241055020638
NYC IDENTIFICATION CARD
NY
01
—
348629715
LEARNER PERMIT
NY
01
—
YSC1790126970
EMPLOYMENT AUTHORIZATION CARD
NY
Enumeration date
09/05/2017
Last updated
12/21/2017
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