Provider Demographics
NPI:1356079164
Name:AN, SUN YOUNG (LPC)
Entity type:Individual
Prefix:
First Name:SUN YOUNG
Middle Name:
Last Name:AN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2290
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AK
Mailing Address - Zip Code:99574-2290
Mailing Address - Country:US
Mailing Address - Phone:907-424-3622
Mailing Address - Fax:907-424-3275
Practice Address - Street 1:705 SECOND ST
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99574-9957
Practice Address - Country:US
Practice Address - Phone:907-424-3622
Practice Address - Fax:907-424-3275
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor