Provider Demographics
NPI:1023242229
Name:CHUNG, KUO-YI (PHD)
Entity type:Individual
Prefix:
First Name:KUO-YI
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S ALMA SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3056
Mailing Address - Country:US
Mailing Address - Phone:480-730-6222
Mailing Address - Fax:480-889-5566
Practice Address - Street 1:1830 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3056
Practice Address - Country:US
Practice Address - Phone:480-730-6222
Practice Address - Fax:480-889-5566
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8850101Y00000X, 101YM0800X
AZ4180103T00000X, 103TC1900X, 103TF0000X, 103TC2200X, 103TC0700X, 103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470798717-26,27-,29Medicaid
NE96097OtherBCBS OF NEBRASKA