Healthcare Provider Details

I. General information

NPI: 1932516986
Provider Name (Legal Business Name): CHIA-YU JUDY YANG LCAT, LMHC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDY YANG LCAT, LMHC, ATR-BC

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BOREN AVENUE SUITE 1300
SEATTLE WA
98104
US

IV. Provider business mailing address

2640 PITKIN AVE
BROOKLYN NY
11208
US

V. Phone/Fax

Practice location:
  • Phone: 425-610-7362
  • Fax:
Mailing address:
  • Phone: 718-827-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60401097
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number13-035
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number001901-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: