Provider Demographics
NPI:1538677091
Name:JUNG, SARA L (CT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:JUNG
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5684 BISCAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4256
Mailing Address - Country:US
Mailing Address - Phone:513-375-9297
Mailing Address - Fax:
Practice Address - Street 1:484 OLD STATE ROUTE 74 # 55
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4239
Practice Address - Country:US
Practice Address - Phone:513-752-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health