Individual provider Active NPI

Xuejun CHI, LCSW

  • Clinical Social Worker
  • Flushing, NY
National Provider Identifier
1750428488
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079755 Issued in NY
Practice address
14015B Sanford Ave
Flushing, NY 11355-2557
Phone
(718) 358-8288
Fax
(718) 358-5265
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11714 NY
Clinical Social Worker 1041C0700X 079755 NY Primary

Addresses

Primary practice location

14015B Sanford Ave
Flushing, NY 11355-2557

Mailing address

140-15B Sanford Ave.
Flushing, NY 11355
Phone (646) 267-6885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11714NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Center of Ny, Inc. CurrentSince Oct 1, 2014 Accepting new patients

Locations

14015 Sanford Ave
Ste B
Flushing, NY 11355
Phone (718) 450-9242

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1750428488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140-15B SANFORD AVE.",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "646-267-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015B SANFORD AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552557",
            "telephone_number": "718-358-8288",
            "fax_number": "718-358-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "XUEJUN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11714",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.