Healthcare Provider Details

I. General information

NPI: 1790433159
Provider Name (Legal Business Name): BAIQIAN ZHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 BROADWAY STE 1200
NEW YORK NY
10010-3450
US

IV. Provider business mailing address

8633 WHITNEY AVE
ELMHURST NY
11373-3657
US

V. Phone/Fax

Practice location:
  • Phone: 347-542-8226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01015200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberTPMC8268
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012224
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: