Provider Demographics
NPI:1861892689
Name:JUNG PSYCH SERVICES LLC
Entity type:Organization
Organization Name:JUNG PSYCH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, FAPA
Authorized Official - Phone:480-775-6423
Mailing Address - Street 1:90 S KYRENE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4687
Mailing Address - Country:US
Mailing Address - Phone:480-775-6423
Mailing Address - Fax:480-775-6425
Practice Address - Street 1:90 S KYRENE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4687
Practice Address - Country:US
Practice Address - Phone:480-775-6423
Practice Address - Fax:480-775-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC1691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty