Healthcare Provider Details

I. General information

NPI: 1417078478
Provider Name (Legal Business Name): CHINO JOY OKONKWO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 W 36TH ST
NEW YORK NY
10018-7598
US

IV. Provider business mailing address

224 AVENUE B APT 18
NEW YORK NY
10009
US

V. Phone/Fax

Practice location:
  • Phone: 212-780-2300
  • Fax:
Mailing address:
  • Phone: 646-228-6036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number073135
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: