Individual
PHUNG MY LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, CDAC-II, MSCP
Contact information
Practice address
1 GATEWAY CTR STE 2600, NEWARK, NJ 07102-5323
(888) 528-7618
Mailing address
228 PARK AVE S, NEW YORK, NY 10003-1502
(267) 999-9534
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
RA9280413
CA
101YP2500X
Professional Counselor
Primary
37PC00989900
NJ
101YP2500X
Professional Counselor
LPCC6684
CA
Other
Enumeration date
10/18/2013
Last updated
03/01/2024
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