Provider Demographics
NPI:1669630745
Name:CHUNN, JAY CARRINGTON (LICSW)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:CARRINGTON
Last Name:CHUNN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 U ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7522
Mailing Address - Country:US
Mailing Address - Phone:202-671-1279
Mailing Address - Fax:202-673-7642
Practice Address - Street 1:1250 U ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7522
Practice Address - Country:US
Practice Address - Phone:202-671-1279
Practice Address - Fax:202-673-7642
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC303386104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker