Provider Demographics
NPI:1922603026
Name:ENGLISH, LAIJUN (MS)
Entity type:Individual
Prefix:
First Name:LAIJUN
Middle Name:
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 OSCAR ENGLISH RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31711-4118
Mailing Address - Country:US
Mailing Address - Phone:718-213-8062
Mailing Address - Fax:
Practice Address - Street 1:930 OSCAR ENGLISH RD
Practice Address - Street 2:
Practice Address - City:ANDERSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:31711-4118
Practice Address - Country:US
Practice Address - Phone:718-213-8062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC014370101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health