Individual provider Active NPI

Nga Ying Chan, LMHC, R-DMT

  • Mental Health Counselor
  • Somerville, MA
National Provider Identifier
1083228571
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10001282 Issued in MA
Practice address
43 Oliver St
Somerville, MA 02145-4127
Phone
(617) 230-7825
NPI assigned
Sep 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10001282 MA Primary

Addresses

Primary practice location

43 Oliver St
Somerville, MA 02145-4127

Mailing address

43 Oliver St
Somerville, MA 02145-4127
Phone (617) 230-7825

Other names 1

  • Angel Chan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10001282MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1083228571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 OLIVER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021454127",
            "telephone_number": "617-230-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 OLIVER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021454127",
            "telephone_number": "617-230-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "NGA YING",
        "name_prefix": "Mrs.",
        "credential": "LMHC, R-DMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10001282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "CHAN",
            "credential": "LMHC, R-DMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.