Individual provider Active NPI

Chamin Ajjan, LCSW, ACT

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1912914508
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071146-1 Issued in NY
Practice address
26 Court St
Suite 1303
Brooklyn, NY 11242-0103
Phone
(917) 476-9381
Fax
(718) 789-1207
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 071146-1 NY Primary

Addresses

Primary practice location

26 Court St
Suite 1303
Brooklyn, NY 11242-0103

Mailing address

26 Court St
Suite 1303
Brooklyn, NY 11242-0103
Phone (917) 476-9381

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
071146-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chamin Ajjan Psychotherapy, LCSW PLLC Clinical CurrentSince Dec 6, 2020 Accepting new patients

Locations

26 Court St
Ste 1303
Brooklyn, NY 11242
Phone (917) 476-9381

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1912914508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COURT ST",
            "address_2": "SUITE 1303",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112420103",
            "telephone_number": "917-476-9381",
            "fax_number": "718-789-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST",
            "address_2": "SUITE 1303",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112420103",
            "telephone_number": "917-476-9381",
            "fax_number": "718-789-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJJAN",
        "first_name": "CHAMIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, ACT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071146-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.