Provider Demographics
NPI:1124423926
Name:CHUNG, YUSHAN HSIEH (MPH, LCSW)
Entity type:Individual
Prefix:MS
First Name:YUSHAN
Middle Name:HSIEH
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MPH, LCSW
Other - Prefix:MISS
Other - First Name:YUSHAN
Other - Middle Name:
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, LCSW
Mailing Address - Street 1:1954 KATELAND CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-6611
Mailing Address - Country:US
Mailing Address - Phone:646-397-0624
Mailing Address - Fax:
Practice Address - Street 1:1954 KATELAND CT
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-6611
Practice Address - Country:US
Practice Address - Phone:646-397-0624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0139471041C0700X
NJ44SC058958001041C0700X
NY0883741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical