Tiong Yee Tan Licensed Clinical Social Worker Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TIONG YEE TAN LICENSED CLINICAL SOCIAL WORKER INC

Practice address

5000 Birch Street West Tower
Suite 3000 Attention: Montes LCSW
Newport Beach, CA 92660-2140

Phone

(949) 229-6943

Fax

(949) 576-3913

NPI assigned

Jun 16, 2022

Organization subpart

No

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

Authorized official

Name

Tiong Yee Tan, LCSW

Title

Director

Phone

(949) 229-6943

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698537600000",
    "number": "1043940505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BIRCH STREET WEST TOWER",
            "address_2": "SUITE 3000 ATTENTION: MONTES LCSW",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602140",
            "telephone_number": "949-229-6943",
            "fax_number": "949-576-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BIRCH STREET WEST TOWER",
            "address_2": "SUITE 3000 ATTENTION: MONTES LCSW",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602140",
            "telephone_number": "949-229-6943",
            "fax_number": "949-576-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIONG YEE TAN LICENSED CLINICAL SOCIAL WORKER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "TIONG YEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "949-229-6943",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.