Imagine Emotional Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

IMAGINE EMOTIONAL WELLNESS

Practice address

3763 83Rd St # 186
Jackson Heights, NY 11372-7146

Phone

(929) 224-0096

NPI assigned

May 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Priscilla ChinNPI 1093228736

Title

Owner

Phone

(929) 224-0096

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Priscilla Chin, LCSW

  • Clinical Social Worker
  • New York, NY
  • NPI 1093228736
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1043909427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 83RD ST # 186",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727146",
            "telephone_number": "929-224-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3763 83RD ST # 186",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727146",
            "telephone_number": "929-224-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE EMOTIONAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "929-224-0096"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY'S STATE BOARD OF SOCIAL WORK EXAMINERS",
            "identifier": "44SC05998700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK OFFICE OF THE PROFESSIONS",
            "identifier": "090366",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC BOARD OF SOCIAL WORK",
            "identifier": "LC200001194",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.