Provider Demographics
NPI:1295291110
Name:CHUN, PHANSY (LCSW)
Entity type:Individual
Prefix:MISS
First Name:PHANSY
Middle Name:
Last Name:CHUN
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 1:833 CHESTNUT ST STE 701
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4409
Mailing Address - Country:US
Mailing Address - Phone:215-503-9935
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST STE 701
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4409
Practice Address - Country:US
Practice Address - Phone:215-503-9935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0200041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical