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General NPI Number Information
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NPI Number | 1336437318
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Entity Type | Individual
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Provider Name | ANGELA CARLETA CHANG PHD, LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 1763 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11236-5037
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Country | US
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Telephone | 718-734-7806
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Fax | 631-920-5111
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Provider Business Mailing Address
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Address Line | 15046 SHORE AVE
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City | JAMAICA
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State | NY
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Zip | 11433-1930
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Country | US
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Telephone | 631-521-4348
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Fax | 631-253-4525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R044643
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License Number State | NY
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