Provider Demographics
NPI:1508402066
Name:SUK, JEE YOUNG
Entity Type:Individual
Prefix:
First Name:JEE YOUNG
Middle Name:
Last Name:SUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 EVERGREEN CT # 6B
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3227
Mailing Address - Country:US
Mailing Address - Phone:202-810-2174
Mailing Address - Fax:
Practice Address - Street 1:7019 EVERGREEN CT # 6B
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3227
Practice Address - Country:US
Practice Address - Phone:202-810-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional