MEDICARE: JIATONG LI LMSW

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	104100000X	Social Worker	127783	NY

General Provider Information

NPI Number	:	1992696215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIATONG LI LMSW

Provider Business Mailing Address
First Line	:	762 59TH ST STE 7
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	762 59TH ST STE 7
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3920
Country	:	US
Telephone Number	:	917-939-1622
Fax Number	:

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

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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Directions to “ JIATONG LI LMSW” Practice Location

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