Provider Demographics
NPI:1336637982
Name:CHONG, DAVID ALFONSO (LPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALFONSO
Last Name:CHONG
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 1:3129 LAZY PALM DR N
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-4218
Mailing Address - Country:US
Mailing Address - Phone:956-536-8363
Mailing Address - Fax:956-230-1386
Practice Address - Street 1:3129 LAZY PALM DR N
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-4218
Practice Address - Country:US
Practice Address - Phone:956-536-8363
Practice Address - Fax:956-230-1386
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional