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General NPI Number Information
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NPI Number | 1104431584
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Entity Type | Individual
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Provider Name | ANTHONY K SUNG LCPC
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Gender | Male
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 5000 W 95TH ST STE 285
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66207-3363
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Country | US
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Telephone | 816-301-4238
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Fax | 913-222-1880
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Provider Business Mailing Address
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Address Line | 5000 W 95TH ST STE 285
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66207-3363
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Country | US
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Telephone | 816-301-4238
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Fax | 913-222-1880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2020011716
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3661
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License Number State | KS
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