Healthcare Provider Details

I. General information

NPI: 1093636516
Provider Name (Legal Business Name): ALYSA CHEUNG LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 E 13TH ST FL 5
BROOKLYN NY
11229-1901
US

IV. Provider business mailing address

1861 STUART ST
BROOKLYN NY
11229-2633
US

V. Phone/Fax

Practice location:
  • Phone: 212-609-7799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128508
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: