Provider Demographics
NPI:1548440449
Name:CHANG, YOUNG S (ASW REGISTERED)
Entity type:Individual
Prefix:MS
First Name:YOUNG
Middle Name:S
Last Name:CHANG
Suffix:
Gender:F
Credentials:ASW REGISTERED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1705
Mailing Address - Country:US
Mailing Address - Phone:213-483-3000
Mailing Address - Fax:213-383-3146
Practice Address - Street 1:1310 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1705
Practice Address - Country:US
Practice Address - Phone:213-483-3000
Practice Address - Fax:213-383-3146
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
CAASW26803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor