| CASE NUMBER | I-200-24099-862879 |
| CASE STATUS | Certified |
| RECEIVED DATE | 4/7/2024 |
| DECISION DATE | 4/12/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Mental Health Counselor |
| SOC CODE | 21-1014.00 |
| SOC TITLE | Mental Health Counselors |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Xu Z Chen Psychiatrist PLLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 837 58th Street |
| EMPLOYER ADDRESS2 | 3rd Floor |
| EMPLOYER CITY | Brooklyn |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11220 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17185763610 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621330 |
| EMPLOYER POC LAST NAME | Chen |
| EMPLOYER POC FIRST NAME | Xu Zhang |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | M.D., President |
| EMPLOYER POC ADDRESS1 | 837 58th Street |
| EMPLOYER POC ADDRESS2 | 3rd Floor |
| EMPLOYER POC CITY | Brooklyn |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 11220 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17185763610 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | drchen6304@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Fang |
| AGENT ATTORNEY FIRST NAME | Peng |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 11 Broadway |
| AGENT ATTORNEY ADDRESS2 | Suite 463 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10004 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12122198869 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | attorneypengfang@fanglawoffices.com |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Peng Fang PC |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | New York State Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 837 58th Street |
| WORKSITE ADDRESS2 | 3rd Floor |
| WORKSITE CITY | Brooklyn |
| WORKSITE COUNTY | KINGS |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 11220 |
| WAGE RATE OF PAY FROM | 57000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $53,165.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-10 |
