Individual
TERESA J KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LISAC
Contact information
Practice address
1554 W VAN BUREN ST, PHOENIX, AZ 85007-2442
(602) 258-6797
(602) 340-9401
Mailing address
1243 W GLENMERE DR, CHANDLER, AZ 85224-7546
(480) 821-2494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10592
AZ
1041C0700X
Clinical Social Worker
LCSW-3551
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
814716
AHCCCS ID
AZ
Enumeration date
10/16/2006
Last updated
09/11/2025
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