Provider Demographics
NPI:1275675084
Name:JUNG, ANITA AMPARA (MS, LPC-S)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:AMPARA
Last Name:JUNG
Suffix:
Gender:F
Credentials:MS, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 BEE CAVES RD STE 120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5523
Mailing Address - Country:US
Mailing Address - Phone:512-879-1942
Mailing Address - Fax:
Practice Address - Street 1:3103 BEE CAVE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5586
Practice Address - Country:US
Practice Address - Phone:512-879-1942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health