Individual provider Active NPI

Josephine Eun Sun Chung, LCSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1134293145
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6867 Issued in OR
Practice address
1601 E 4TH Plain Blvd BLDG 18
Vancouver, WA 98661-3717
Phone
(971) 334-9185
Fax
(360) 737-1424
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22774 CA
Clinical Social Worker 1041C0700X L6867 OR Primary

Addresses

Primary practice location

1601 E 4TH Plain Blvd BLDG 18
Vancouver, WA 98661-3717

Mailing address

1601 E 4TH Plain Blvd BLDG 18
Vancouver, WA 98661-3717
Phone (971) 334-9185

Other practice location 1

201 Centre Plaza Dr
Dept. 425
Monterey Park, CA 91754-2142
Phone (323) 526-6837

Other names 1

  • Josephine Eun Sun Won Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Josephine.Chung@VA.gov Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L6867ORMDClinical Social Worker
22774CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1134293145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD BLDG 18",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "971-334-9185",
            "fax_number": "360-737-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD BLDG 18",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "971-334-9185",
            "fax_number": "360-737-1424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Centre Plaza Dr",
            "address_2": "Dept. 425",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917542142",
            "country_code": "US",
            "telephone_number": "323-526-6837",
            "fax_number": "323-260-5251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JOSEPHINE",
        "middle_name": "EUN SUN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "22774",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Josephine.Chung@VA.gov",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "telephone",
            "address_1": "1601 E 4th Plain Blvd Bldg 18",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986613717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOSEPHINE",
            "last_name": "WON",
            "middle_name": "EUN SUN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.