Healthcare Provider Details

I. General information

NPI: 1518539139
Provider Name (Legal Business Name): YUJUNG OH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBIRDGE ST
KANSAS CITY KS
66160-8505
US

IV. Provider business mailing address

2917 W 144TH TER
LEAWOOD KS
66224-3950
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 650-930-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC04111
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC03918
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: