Provider Demographics
NPI:1124557954
Name:CHENG, PATRICK CHIH-YUNG (LCPC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CHIH-YUNG
Last Name:CHENG
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 1:13912 MUSTANG HILL LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3871
Mailing Address - Country:US
Mailing Address - Phone:703-869-5731
Mailing Address - Fax:
Practice Address - Street 1:6237 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:240-464-8000
Practice Address - Fax:240-383-3439
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD448801600Medicaid