Provider Demographics
NPI:1104535467
Name:LI, MIN (LMSW)
Entity type:Individual
Prefix:
First Name:MIN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 58TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3662
Mailing Address - Country:US
Mailing Address - Phone:718-686-1533
Mailing Address - Fax:718-686-8121
Practice Address - Street 1:837 58TH ST FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3662
Practice Address - Country:US
Practice Address - Phone:718-686-1533
Practice Address - Fax:718-686-8121
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118197104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker