Provider Demographics
NPI:1487006110
Name:CHEN, LING LENIA
Entity type:Individual
Prefix:
First Name:LING
Middle Name:LENIA
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LING
Other - Middle Name:
Other - Last Name:NIETLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2749 RUM CREEK DR SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5279
Mailing Address - Country:US
Mailing Address - Phone:616-309-5314
Mailing Address - Fax:
Practice Address - Street 1:421 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:CEDAR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49319-8136
Practice Address - Country:US
Practice Address - Phone:616-918-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician