Provider Demographics
NPI:1558079319
Name:CHUNG, DANIEL (MED, EDS, LPC-A)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MED, EDS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8431 KATY FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1931
Mailing Address - Country:US
Mailing Address - Phone:713-955-4302
Mailing Address - Fax:
Practice Address - Street 1:8431 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1931
Practice Address - Country:US
Practice Address - Phone:713-955-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty