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
Phone: (520) 550-6041
Fax: (520) 550-6033
Website:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104056613 | NPPES |
| Arizona | MEDICAID | 346214 |
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