Provider Demographics
NPI:1255603221
Name:JEONG, ANNE GEUMHWA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:GEUMHWA
Last Name:JEONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 PARKLAKE VLG
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6688
Mailing Address - Country:US
Mailing Address - Phone:281-578-2083
Mailing Address - Fax:281-578-2083
Practice Address - Street 1:1915 PARKLAKE VLG
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6688
Practice Address - Country:US
Practice Address - Phone:281-578-2083
Practice Address - Fax:281-578-2083
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX412231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical