Mia Gabrielle Chung

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A21214 Issued in NC

Practice address

5 Silva Terra Dr Ste 110
Wilmington, NC 28412-2373

Phone

(910) 233-2997

NPI assigned

Feb 9, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1033863907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SILVA TERRA DR STE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122373",
            "telephone_number": "910-233-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SILVA TERRA DR STE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122373",
            "telephone_number": "910-233-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MIA",
        "middle_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A21214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chrysalis Center for Counseling and Eating Disorder Treatment PLLC
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• Chrysalis Home Care LLC
• Sarah Chudacek
• Eva Church, MSW, LCSWA
• Jeffrey Scott Church, M.D.
• Celeste M Cianciulli, LCSW
• Sonya Jean Ciancutti, LCSW
• Dominic Ciccocioppo

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.