Provider Demographics
NPI:1093468670
Name:PAK, JOSEPH CHUNMIN
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHUNMIN
Last Name:PAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 HAW CREEK CIR STE 403
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6567
Mailing Address - Country:US
Mailing Address - Phone:770-940-9679
Mailing Address - Fax:
Practice Address - Street 1:1435 HAW CREEK CIR STE 403
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6567
Practice Address - Country:US
Practice Address - Phone:770-940-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0083001041C0700X
GAMSW0047341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical