Tina Timmy Chung, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW66394 Issued in CA

Practice address

2311 W El Segundo Blvd
Hawthorne, CA 90250-3315

Phone

(323) 241-6730

NPI assigned

Aug 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tina NG Chung Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1083920276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W EL SEGUNDO BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503315",
            "telephone_number": "323-241-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 W EL SEGUNDO BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503315",
            "telephone_number": "323-241-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TINA",
        "middle_name": "TIMMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW66394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "CHUNG",
            "middle_name": "NG",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Social Worker in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.