Justin Chen, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4748 Issued in AZ

Practice address

6106 Tennessee Ave
Fort Campbell, KY 42223-5940

Phone

(610) 772-3898

NPI assigned

Mar 24, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1366869844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6106 TENNESSEE AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235940",
            "telephone_number": "610-772-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6106 TENNESSEE AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235940",
            "telephone_number": "610-772-3898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "984311000",
            "country_code": "US",
            "telephone_number": "800-404-4506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanika Chaudhuri, MD
• John Fernando Chaves, M.D.
• John Cye Cheasty
• Brent Michael Chelewski, PHARMD
• Jeffery Chen, DMD
• Tracy A Chew
• John Michael Childress Jr., LCSW
• Ashley Chinn
• Benson Chiong, PHARMD
• Abigail L Chirco

• Clinical Psychologist in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.