=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457674251
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARMEN PAZ CHANG-ARRATIA LCSW-R
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2010
-----------------------------------------------------
Last Update Date | 06/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 W 35TH ST STE 1001
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-2114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-522-0404
-----------------------------------------------------
Fax | 267-851-4762
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 W 35TH ST STE 1001
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-2114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-522-0404
-----------------------------------------------------
Fax | 267-851-4762
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | R078583-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------