Provider Demographics
NPI:1730552902
Name:JING, XIANQIAN FYONA (LMSW)
Entity type:Individual
Prefix:
First Name:XIANQIAN
Middle Name:FYONA
Last Name:JING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13226 AVERY AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4954
Mailing Address - Country:US
Mailing Address - Phone:718-353-6788
Mailing Address - Fax:718-353-6588
Practice Address - Street 1:13226 AVERY AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4954
Practice Address - Country:US
Practice Address - Phone:718-353-6788
Practice Address - Fax:718-353-6588
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092681104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker