Provider Demographics
NPI:1245529981
Name:JUNG, SHARI PORTER (LCSW, LMFT, CGP)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:PORTER
Last Name:JUNG
Suffix:
Gender:F
Credentials:LCSW, LMFT, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 MCKINNEY AVE # 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3357
Mailing Address - Country:US
Mailing Address - Phone:214-780-0220
Mailing Address - Fax:
Practice Address - Street 1:5210 MCKINNEY AVE # 225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3357
Practice Address - Country:US
Practice Address - Phone:214-780-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXO15871041C0700X
TX2425106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist