Provider Demographics
NPI:1548958762
Name:MU, YI-CHEN (LMSW)
Entity type:Individual
Prefix:
First Name:YI-CHEN
Middle Name:
Last Name:MU
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:YICHEN
Other - Middle Name:
Other - Last Name:MU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:11045 71ST RD APT 6E
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4967
Mailing Address - Country:US
Mailing Address - Phone:917-691-2611
Mailing Address - Fax:
Practice Address - Street 1:184 ELDRIDGE ST RM 404
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-2992
Practice Address - Country:US
Practice Address - Phone:212-453-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119109-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker