# HEEJUNG PARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275237521
- **Gender:** F
- **Credential:** SUDPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | MC61576931 | WA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | CO61420788 | WA | — |

## Other

- **Enumeration date:** 03/29/2023
- **Last updated:** 11/05/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CO61420788 | SUDPT | WA |
| 01 | — | MC61576931 | MENTAL HEALTH COUNSELOR ASSOCIATE LICENSE | WA |