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NPI Code Detail

MEDICARE: MAN CHUNG CHONG

MEDICARE: MAN CHUNG CHONG
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
1101YM0800XMental Health Counselor
2101Y00000XCounselor

General Provider Information

NPI Number : 1861172744
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAN CHUNG CHONG
Provider Business Mailing Address
First Line : 61 INNERBELT RD
Second Line :
City : SOMERVILLE
State : MA
Zip : 02143-4416
Country : US
Telephone Number : 857-895-6514
Fax Number :
Provider Business Practice Location Address
First Line : 61 INNERBELT RD
Second Line :
City : SOMERVILLE
State : MA
Zip : 02143-4416
Country : US
Telephone Number : 857-895-6514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2023
Last Update Date : 01/14/2026

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Directions to “ MAN CHUNG CHONG ” Practice Location

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