Chan, Kathleen Ann

Chan, Kathleen Ann is an individual health care provider with primary practice located at 4577 W Pecos Rd , Laveen AZ 85339. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Chan, Kathleen Ann can be contacted via phone (520) 550-6041.

Contact Information

Primary practice address
4577 W Pecos Rd Laveen AZ 85339
Fax: (520) 550-6033
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-3864 Arizona

Profile Details

NPI number 1104056613
LBN Legal business name Chan, Kathleen Ann
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2009
Last updated Jul 17th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104056613 NPPES
Arizona MEDICAID 346214

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