Active NPI
Eric Chung
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1629769906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 115318
- Practice address
- 515 Columbia Ave
Los Angeles, CA 90017-1209 - Phone
- (213) 553-1884
- NPI assigned
- May 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 115318 | CA | |
| Mental Health Counselor | 101YM0800X | 115318 | CA | Primary |
Addresses
Primary practice location
515 Columbia Ave
Los Angeles, CA 90017-1209
Mailing address
515 Columbia Ave
Los Angeles, CA 90017-1209
Phone (213) 553-1884
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
| License | State | Type | Specialty |
|---|---|---|---|
| 115318 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1629769906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 COLUMBIA AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171209",
"telephone_number": "213-553-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 COLUMBIA AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171209",
"telephone_number": "213-553-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "ERIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-17",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "115318",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "115318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.