Susan B Jung, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003429 Issued in GA

Practice address

2061 Bethel Rd NE
Conyers, GA 30012-1530

Phone

(770) 776-8446

NPI assigned

Jan 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1881925659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 BETHEL RD NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300121530",
            "telephone_number": "770-776-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 BETHEL RD NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300121530",
            "telephone_number": "770-776-8446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 James Currie Rd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310211489",
            "country_code": "US",
            "telephone_number": "770-776-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SUSAN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003429",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "003429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Conyers, GA
• Providers in Conyers, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.