Provider Demographics
NPI:1356234157
Name:CHOU, CHIN-YANG MARIKO (LCSW)
Entity type:Individual
Prefix:
First Name:CHIN-YANG
Middle Name:MARIKO
Last Name:CHOU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIKO
Other - Middle Name:
Other - Last Name:CHOU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:11510 MAGNOLIA VIEW CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5865
Mailing Address - Country:US
Mailing Address - Phone:502-777-1395
Mailing Address - Fax:
Practice Address - Street 1:4229 BARDSTOWN RD STE 310
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3266
Practice Address - Country:US
Practice Address - Phone:502-416-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2603431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical