Provider Demographics
NPI:1851892871
Name:CHUNG, COURTNEYROSE (LMFT, LPC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEYROSE
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:LMFT, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 MESA VERDE PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3010
Mailing Address - Country:US
Mailing Address - Phone:310-902-2930
Mailing Address - Fax:
Practice Address - Street 1:9233 PARK MEADOWS DR STE 121
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5698
Practice Address - Country:US
Practice Address - Phone:720-504-4329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001481101YA0400X
COLPCC.0015832101YM0800X
COLPC.0016140101YP2500X
COMFTC.0013762106H00000X
COMFT.0001834106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional