Provider Demographics
NPI:1730259433
Name:CHENG, YUN-JU (PHD)
Entity type:Individual
Prefix:DR
First Name:YUN-JU
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:YUN-JU
Other - Middle Name:
Other - Last Name:CHENG MARKOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1105
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-1105
Mailing Address - Country:US
Mailing Address - Phone:307-864-0003
Mailing Address - Fax:360-227-7465
Practice Address - Street 1:148 E ARAPAHOE ST
Practice Address - Street 2:
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2402
Practice Address - Country:US
Practice Address - Phone:307-864-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14765103T00000X
WAPY00003782103T00000X
WY720103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY484338000OtherMAGELLAN
NY7547434OtherAETNA
NY488138OtherVALUE OPTIONS
NYP2595238OtherOXFORD
NY7352564OtherGHI
NYP2595238OtherOXFORD
NY7547434OtherAETNA