Provider Demographics
NPI:1922693548
Name:JUNG, DA WOON (MA, BC-TMH)
Entity Type:Individual
Prefix:MS
First Name:DA WOON
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:MA, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 GALLOWS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3823
Mailing Address - Country:US
Mailing Address - Phone:703-761-2225
Mailing Address - Fax:703-761-2228
Practice Address - Street 1:1952 GALLOWS RD STE 210
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3823
Practice Address - Country:US
Practice Address - Phone:703-761-2225
Practice Address - Fax:703-761-2228
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704012634101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor