Basic Information
| Provider Information | |||||||||
| NPI: | 1720001068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHOI | ||||||||
| FirstName: | HEAIN | ||||||||
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| Credential: | MA, MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23 BADGLEY DR | ||||||||
| Address2: | |||||||||
| City: | NEW PROVIDENCE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079742501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086650179 | ||||||||
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| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD | ||||||||
| Address2: | |||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
| FaxNumber: | 9086045227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 44SC00573800 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.