Provider Demographics
NPI:1013208909
Name:YUN, SOYOUNG (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SOYOUNG
Middle Name:
Last Name:YUN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4554 LEONORA DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2820
Mailing Address - Country:US
Mailing Address - Phone:850-496-7880
Mailing Address - Fax:
Practice Address - Street 1:11675 CENTURY DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8366
Practice Address - Country:US
Practice Address - Phone:678-740-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health