Individual provider Active NPI

Chen Chen

  • Social Worker
  • Flushing, NY
National Provider Identifier
1700304250
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
102306-1 Issued in NY
Practice address
14015B Sanford Ave FL 2
Flushing, NY 11355-2557
Phone
(718) 358-8288
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Social Worker 104100000X 102306-1 NY Primary

Addresses

Primary practice location

14015B Sanford Ave FL 2
Flushing, NY 11355-2557

Mailing address

506 W 122ND St Apt 4
New York, NY 10027-5850
Phone (929) 371-9805

Other identifiers 3

IdentifierTypeStateIssuer
348629715OtherNYLEARNER PERMIT
16241055020638OtherNYNYC IDENTIFICATION CARD
YSC1790126970OtherNYEMPLOYMENT AUTHORIZATION CARD

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
102306-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1700304250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 W 122ND ST APT 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275850",
            "telephone_number": "929-371-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015B SANFORD AVE FL 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552557",
            "telephone_number": "718-358-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "CHEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "102306-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEARNER PERMIT",
            "identifier": "348629715",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYC IDENTIFICATION CARD",
            "identifier": "16241055020638",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYMENT AUTHORIZATION CARD",
            "identifier": "YSC1790126970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.