Provider Demographics
NPI:1447313077
Name:PARK, ISABEL JEEHYUN SONG (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:JEEHYUN SONG
Last Name:PARK
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22648 GLENN DR
Mailing Address - Street 2:UNIT 302
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-4495
Mailing Address - Country:US
Mailing Address - Phone:703-596-1841
Mailing Address - Fax:
Practice Address - Street 1:22648 GLENN DR
Practice Address - Street 2:UNIT 302
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-4495
Practice Address - Country:US
Practice Address - Phone:703-596-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health