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Physician Compare National (NPI:1205936804)

HEALTHCARE PROVIDER: YUDIT JUNG PH.D., LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1205936804
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6002833993
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20051031000236
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name JUNG
Individual professional last name
Provider First Name YUDIT
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.
Provider Credential Text CSW
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1983
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 1924 CLAIRMONT RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 210
Group Practice or individual's line 2 address
City DECATUR
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 300333450
Group Practice or individual's zip code (9 digits when available)
Phone Number 4042885126
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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