Kyung Chang, LCSW

Individual provider Active NPI Clinical Social Worker · Ridgefield, NJ

NPI 1811213432 · NPPES record last updated Apr 8, 2010

Key facts

NPI
1811213432
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC05237500 (NJ)
Practice address
581 Bergen Blvd
#4
Ridgefield, NJ 07657-2030
Phone
(201) 313-3346
Fax
(718) 888-1876
NPI assigned
Apr 8, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
44SC05237500NJMDMental Health Counselor
R032790-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R032790-1 NY
Addiction (Substance Use Disorder) Counselor 101YA0400X 44SC05237500 NJ
Mental Health Counselor 101YM0800X R032790-1 NY
Mental Health Counselor 101YM0800X 44SC05237500 NJ
Clinical Social Worker 1041C0700X R032790-1 NY
Clinical Social Worker 1041C0700X 44SC05237500 NJ Yes
School Social Worker 1041S0200X R032790-1 NY
School Social Worker 1041S0200X 44SC05237500 NJ
Marriage & Family Therapist 106H00000X R032790-1 NY
Marriage & Family Therapist 106H00000X 44SC05237500 NJ

Addresses

Primary practice location

581 Bergen Blvd
#4
Ridgefield, NJ 07657-2030

Mailing address

3901 Main St
#508
Flushing, NY 11354-5432
Phone (201) 313-3346

Other names

  • Ms. Mina Kyung Chang Professional name

Other providers in Ridgefield, NJ

All providers in Ridgefield, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.