Provider Demographics
NPI:1528572724
Name:CHA, JAE SEUNG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAE SEUNG
Middle Name:
Last Name:CHA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20680 SENECA MEADOWS PKWY STE 217
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7029
Mailing Address - Country:US
Mailing Address - Phone:301-569-6326
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY STE 217
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7029
Practice Address - Country:US
Practice Address - Phone:301-569-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist