MEDICARE: MINKYUNG CHUNG LMHC 13929

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LMHC 13929	FL

General Provider Information

NPI Number	:	1720470081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINKYUNG CHUNG LMHC 13929

Provider Business Mailing Address
First Line	:	1314 E LAS OLAS BLVD # 1704
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2334
Country	:	US
Telephone Number	:	407-801-9537
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 E LAS OLAS BLVD # 1704
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2334
Country	:	US
Telephone Number	:	407-801-9537
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	05/06/2026

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