Provider Demographics
NPI:1578390100
Name:CHUNG, SOPHIA SONG HUI (LCMHCA)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:SONG HUI
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 TATE BLVD SE STE 202
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4252
Mailing Address - Country:US
Mailing Address - Phone:828-758-1320
Mailing Address - Fax:828-758-1332
Practice Address - Street 1:1781 TATE BLVD SE STE 202
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4252
Practice Address - Country:US
Practice Address - Phone:828-758-1320
Practice Address - Fax:828-758-1332
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health