Individual ProviderJi Hwan ChaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address8900 Van Wyck Expy, Jamaica, NY 11418-2832(718) 206-6000(737) 710-6816PECOS EnrollmentBased on the most recent information from CMS, provider Ji Hwan Cha does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1518567593Provider TypeIndividualFull NameCha, Ji HwanCredentialLCSWGenderMaleSole ProprietorNoEnumeration Date10/28/2020Last Updated4/3/2024Contact InformationPractice LocationPractice Address8900 Van Wyck Expy, Jamaica, NY 11418-2832Phone(718) 206-6000FaxUnlisted FaxMailing LocationMailing Address8900 Van Wyck Expy, Jamaica, NY 11418-2832Phone(737) 710-6816FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense095063New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense107353New York