Basic Information
| Provider Information | |||||||||
| NPI: | 1922385848 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | CHING-HSUAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5504 84TH ST # 3 | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113734730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9177832387 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14015B SANFORD AVE | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113552557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183588288 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2011 | ||||||||
| LastUpdateDate: | 11/06/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 084431 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.