Basic Information
Provider Information
NPI: 1770074189
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHIU
FirstName: CHIH-YUN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MHC-LP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 323 W 96TH ST APT 604
Address2:  
City: NEW YORK
State: NY
PostalCode: 100256279
CountryCode: US
TelephoneNumber: 9177037309
FaxNumber:  
Practice Location
Address1: 115 W 31ST ST FL 5
Address2:  
City: NEW YORK
State: NY
PostalCode: 100013596
CountryCode: US
TelephoneNumber: 2125646006
FaxNumber: 2125643440
Other Information
ProviderEnumerationDate: 05/21/2018
LastUpdateDate: 05/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XP10283NYY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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