Provider Demographics
NPI:1447823224
Name:CHONG, YOO JUNG (MA ED, LMHCA)
Entity type:Individual
Prefix:MS
First Name:YOO JUNG
Middle Name:
Last Name:CHONG
Suffix:
Gender:F
Credentials:MA ED, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 4TH AVE STE 4200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98154-1154
Mailing Address - Country:US
Mailing Address - Phone:206-395-5842
Mailing Address - Fax:
Practice Address - Street 1:1818 E MERCER ST STE 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4689
Practice Address - Country:US
Practice Address - Phone:206-681-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61163038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health