Provider Demographics
NPI:1164990974
Name:CHO, TAKHYUN (LPC)
Entity Type:Individual
Prefix:DR
First Name:TAKHYUN
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 MAIN ST STE 508
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7173
Mailing Address - Country:US
Mailing Address - Phone:703-277-9515
Mailing Address - Fax:
Practice Address - Street 1:10560 MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7176
Practice Address - Country:US
Practice Address - Phone:202-295-7069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional