Provider Demographics
NPI:1396617676
Name:PARK, JINSUN
Entity type:Individual
Prefix:
First Name:JINSUN
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 FEARING ST STE 25
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1942
Mailing Address - Country:US
Mailing Address - Phone:413-206-6261
Mailing Address - Fax:
Practice Address - Street 1:150 FEARING ST STE 25
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1942
Practice Address - Country:US
Practice Address - Phone:413-206-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health