Provider Demographics
NPI:1104431584
Name:SUNG, ANTHONY K (LCPC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:K
Last Name:SUNG
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W 95TH ST STE 285
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3363
Mailing Address - Country:US
Mailing Address - Phone:816-301-4238
Mailing Address - Fax:913-222-1880
Practice Address - Street 1:5000 W 95TH ST STE 285
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-3363
Practice Address - Country:US
Practice Address - Phone:816-301-4238
Practice Address - Fax:913-222-1880
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020011716101YP2500X
KS3661101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional