Provider Demographics
NPI:1346904844
Name:CHUNG, SAMUEL HONGMIN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:HONGMIN
Last Name:CHUNG
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10905 SE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-7306
Mailing Address - Country:US
Mailing Address - Phone:310-254-4071
Mailing Address - Fax:
Practice Address - Street 1:10905 SE 23RD ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7306
Practice Address - Country:US
Practice Address - Phone:310-254-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60802515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health