Provider Demographics
NPI:1932818234
Name:CHUNG, JADE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 NE WATERS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3533
Mailing Address - Country:US
Mailing Address - Phone:561-365-8421
Mailing Address - Fax:
Practice Address - Street 1:678 NE WATERS EDGE LN
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3533
Practice Address - Country:US
Practice Address - Phone:561-365-8421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25934101YM0800X
FL16995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health