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NPI Code Detail

MEDICARE: KELLIE CHEN LCSW

MEDICARE: KELLIE CHEN 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
11041C0700XClinical Social Worker59375TX

General Provider Information

NPI Number : 1710295688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE CHEN LCSW
Provider Business Mailing Address
First Line : PO BOX 230209
Second Line :
City : HOUSTON
State : TX
Zip : 77223-0209
Country : US
Telephone Number : 713-660-1880
Fax Number :
Provider Business Practice Location Address
First Line : 7635 CANAL ST
Second Line :
City : HOUSTON
State : TX
Zip : 77012-1143
Country : US
Telephone Number : 713-773-0803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2010
Last Update Date : 01/23/2015

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Directions to “ KELLIE CHEN LCSW” Practice Location

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