Active NPI
Suyeon Jung
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1174433379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 96305
- Practice address
- 4500 Mercantile Plaza Dr Ste 307
Fort Worth, TX 76137-4230 - Phone
- (817) 754-7976
- Fax
- (817) 232-9403
- NPI assigned
- Sep 9, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 96305 | TX | Primary |
Addresses
Primary practice location
4500 Mercantile Plaza Dr Ste 307
Fort Worth, TX 76137-4230
Mailing address
2832 Red Wolf Dr
Fort Worth, TX 76244-5505
Phone (214) 971-6443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1174433379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2832 RED WOLF DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445505",
"telephone_number": "214-971-6443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 MERCANTILE PLAZA DR STE 307",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374230",
"telephone_number": "817-754-7976",
"fax_number": "817-232-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "SUYEON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-09",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "96305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.