Active NPI
Paul Chang
- Clinical Social Worker
- Las Vegas, NV
National Provider Identifier
1396197612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 080505
- Practice address
- 4461 E Charleston Blvd RM 188
Las Vegas, NV 89104-5537 - Phone
- (516) 241-1954
- NPI assigned
- Jul 11, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 080505 | NY | Primary |
Addresses
Primary practice location
4461 E Charleston Blvd RM 188
Las Vegas, NV 89104-5537
Mailing address
1150 Grass Pond PL Unit 103
Henderson, NV 89002-9466
Phone (516) 241-1954
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 080505 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1396197612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 GRASS POND PL UNIT 103",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890029466",
"telephone_number": "516-241-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4461 E CHARLESTON BLVD RM 188",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891045537",
"telephone_number": "516-241-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "PAUL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-11",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "080505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.