MEDICARE: TIN YAN YEUNG LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	101160	NY
2	104100000X	Social Worker	11577801	NY

General Provider Information

NPI Number	:	1104527605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIN YAN YEUNG LCSW

Provider Business Mailing Address
First Line	:	3443 CRESCENT ST APT 2J
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-3961
Country	:	US
Telephone Number	:	408-382-9197
Fax Number	:

Provider Business Practice Location Address
First Line	:	749 61ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5162
Country	:	US
Telephone Number	:	718-362-6311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	12/16/2025

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