Jin Li Chan, LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JIN LI CHAN, LCSW, LLC

Practice address

37 Ledge Rd
Lyndonville, VT 05851-4000

Phone

(802) 391-4378

NPI assigned

Sep 16, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jin Li Chan, MSW, LCSW, PMH-CNPI 1023551710

Title

Owner

Phone

(802) 391-4378

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jin Li Chan, LICSW

  • Clinical Social Worker
  • St Johnsbury, VT
  • NPI 1023551710
  NPD Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1790512523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "LYNDON",
            "state": "VT",
            "postal_code": "058490033",
            "telephone_number": "802-391-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 LEDGE RD",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058514000",
            "telephone_number": "802-391-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIN LI CHAN, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JIN LI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-391-4378",
        "authorized_official_credential": "MSW, LCSW, PMH-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kate T. Kearnan, MSW
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• Logan Samuel Krass
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• Clinical Social Worker in Lyndonville, VT
• Providers in Lyndonville, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.