Provider Demographics
NPI:1750265435
Name:CHUNG, KI KI (PHD, LPC, LMHC, RPT)
Entity type:Individual
Prefix:DR
First Name:KI KI
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHD, LPC, LMHC, RPT
Other - Prefix:DR
Other - First Name:REGINE
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPC, LMHC, RPT
Mailing Address - Street 1:5151 HEADQUARTERS DR STE 240
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5151 HEADQUARTERS DR STE 240
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0021
Practice Address - Country:US
Practice Address - Phone:469-200-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61540481101YM0800X
TX83991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health