Provider Demographics
NPI:1386412625
Name:CHA, HYUN AH (LMSW)
Entity type:Individual
Prefix:MS
First Name:HYUN
Middle Name:AH
Last Name:CHA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:CHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2040 BROOKE FOREST CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-3418
Mailing Address - Country:US
Mailing Address - Phone:407-697-0944
Mailing Address - Fax:
Practice Address - Street 1:1830 WATER PL SE # 215
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-7407
Practice Address - Country:US
Practice Address - Phone:407-697-0944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011232104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker