Provider Demographics
NPI:1649167099
Name:CHOI, JONG WON
Entity type:Individual
Prefix:
First Name:JONG WON
Middle Name:
Last Name:CHOI
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 1:322 RICHARD MINE RD APT N4
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-1815
Mailing Address - Country:US
Mailing Address - Phone:201-298-3190
Mailing Address - Fax:
Practice Address - Street 1:50 UPPER MONTCLAIR PLZ STE 208
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1347
Practice Address - Country:US
Practice Address - Phone:201-298-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00769100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional