Healthcare Provider Details

I. General information

NPI: 1902448194
Provider Name (Legal Business Name): NATALIE JEUNG MA, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N CASS AVE STE 115
WESTMONT IL
60559-6401
US

IV. Provider business mailing address

825 N CASS AVE STE 115
WESTMONT IL
60559-6401
US

V. Phone/Fax

Practice location:
  • Phone: 331-251-3756
  • Fax:
Mailing address:
  • Phone: 331-251-3756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.014641
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: