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General NPI Number Information
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NPI Number | 1386652865
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Entity Type | Individual
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Provider Name | KERRY J JUNG LPC
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1173 W MAIN ST
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City | WHITEWATER
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State | WI
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Zip | 53190-1672
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Country | US
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Telephone | 920-728-4416
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Fax |
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Provider Business Mailing Address
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Address Line | N1607 POEPPEL RD
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City | FORT ATKINSON
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State | WI
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Zip | 53538-9329
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Country | US
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Telephone | 920-728-7121
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Fax |
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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 | 3517125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3517
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License Number State | WI
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