MISS FONG CHAN (NPI# 1336479914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336479914 |
| Entity Type | Individual |
| Full Name | MISS FONG CHAN |
| Credential | MSW |
| Practice Address |
1040 Waltham St Lexington MA 02421-8033 |
| Practice Telephone | 7818623600 |
| Practice Fax Number | 7818635903 |
| Mailing Telephone | 7818623600 |
| Mailing Fax Number | 7818635903 |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BMC | 0000023532 | 01 |
| MA | TAX ID | 042611055 | 01 |
| MA | MBHP | 1303287 | 01 |
| MA | NHP | 1004745 | 01 |
| MA | NETWORK HEALTH | 99618201 | 01 |
| MA | 1303287 | 05 | |
| MA | BCBS | M18633 | 01 |
| Street Address |
1040 WALTHAM ST |
| City | LEXINGTON |
| State | MA |
| Zip Code | 02421-8033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649219023 | Matthew Paul Snell | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2006-06-04 |
| 1972046100 | Anthony Pflugradt | Behavior Technician | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-11-20 |
| 1518409671 | Hyun-zie Tara Hong | Social Worker | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-11-07 |
| 1427500057 | Jessica Miyu Magyar | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-10-31 |
| 1427509249 | Francis Connelly | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-10-17 |
| 1033668546 | Monique Mitchell | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-09-26 |
| 1952859647 | Kimberly Tucker | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-09-12 |
| 1386192086 | Kelly Swartz | Social Worker | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-09-12 |
| 1477001170 | Kate Tessmann | Social Worker | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-09-12 |
| 1891243580 | Michelle Galper | Counselor | 1040 Waltham St, Lexington, MA 02421-8033 | 2016-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149300 | Streettherapy,llc | Counselor | Triad Adolescent Services, 363 Mass. Ave., Suite204, Lexington, MA 02421 | 2019-11-20 |
| 1598249922 | Kelly Sexton | Social Worker | Labbb Collaborative Lexington High School, 251 Waltham St, MA 02421 | 2018-09-21 |
| 1538641956 | Jill Or Planeta | Social Worker | 40 Taft Ave, Lexington, MA 02421 | 2018-09-01 |
| 1902390388 | Erika Yaneth Valek | Counselor | 125 Hartwell Avenue, Lexington, MA 02421 | 2018-06-19 |
| 1366743668 | Elizabeth Ann Murphy | Social Worker | 17 Stedman Rd, Lexington, MA 02421 | 2010-11-03 |
| 1003045063 | Nils Becker | Pathology | 1 Cranberry Hill Ste 303, Lexington, MA 02421 | 2009-07-10 |
| 1780829556 | Lynn Joan Meltzer | Psychologist | Institute for Learning and Development, 4 Militia Drive, Lexington, MA 02421 | 2008-12-09 |
| 1962666511 | Kristin Stanley Rullo | Optometrist | 21 Worthen Road, Lexington, MA 02421 | 2008-07-14 |
| 1861660201 | Jillian S Imagire | Radiology | Concert Pharmaceuticals, 99 Hayden Ave, Suite 100, Lexington, MA 02421 | 2008-02-20 |
| 1144498049 | Lexington Dental Associates | Dentist | 271 Lincoln Street, Suite 2, Lexington, MA 02421 | 2008-02-13 |
| Find all providers in zip 02421 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
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| 1306450739 | Rebeca Griffith | Counselor | 304 Grey Oaks Ct, Lexington, SC 29072-7418 | 2020-09-02 |
| 1164034294 | Ashlyn Brooke Bordelon | Counselor | 113 Ivy Hill Ct, Lexington, SC 29072-8054 | 2020-08-19 |
| 1720698897 | Tracy Mae Springate | Counselor | 750 Shaker Dr Apt 202, Lexington, KY 40504-3725 | 2020-08-04 |
| 1760090724 | Statera Counseling, LLC | Counselor | 281 Governors Grant Blvd, Lexington, SC 29072-8826 | 2020-07-16 |
| 1396361374 | Courtney Scott | Counselor | 1666 Massachusetts Ave Fl 2, Lexington, MA 02420-5313 | 2020-06-24 |
| 1144846684 | A Better Way | Counselor | 366 Waller Ave Ste 213, Lexington, KY 40504-2921 | 2020-06-21 |
| 1366067381 | Kadie Ann Bourgoin | Counselor | 230 White Oleander Dr, Lexington, SC 29072-7037 | 2020-06-15 |
| 1629690672 | Summit Counseling Center | Counselor | 145 Burt Rd Ste 19, Lexington, KY 40503-2401 | 2020-05-13 |
| 1083240709 | Seung Hee Oh | Counselor | 7 Stedman Rd Apt 301, Lexington, MA 02421-7133 | 2020-03-13 |
| Find all providers in LEXINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.