Provider Demographics
NPI:1972905362
Name:JEAN, ALIN (LCSW)
Entity type:Individual
Prefix:
First Name:ALIN
Middle Name:
Last Name:JEAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-6203
Mailing Address - Country:US
Mailing Address - Phone:718-498-9898
Mailing Address - Fax:718-495-3684
Practice Address - Street 1:2108 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-7411
Practice Address - Country:US
Practice Address - Phone:718-498-9898
Practice Address - Fax:718-495-3684
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO45720-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR045720-1OtherNYS LICENSE