Provider Demographics
NPI:1295698421
Name:LY TAN, LING
Entity type:Individual
Prefix:
First Name:LING
Middle Name:
Last Name:LY TAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHHENG
Other - Middle Name:LING
Other - Last Name:LY TAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7895 S DAYTON ST UNIT 266
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4971
Mailing Address - Country:US
Mailing Address - Phone:310-462-8384
Mailing Address - Fax:
Practice Address - Street 1:7895 S DAYTON ST UNIT 266
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80112-4971
Practice Address - Country:US
Practice Address - Phone:310-462-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-12-12006103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst