Provider Demographics
NPI:1689074841
Name:CHUN, GINGER MAIN (LCSW)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:MAIN
Last Name:CHUN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15203 ELKTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3911
Mailing Address - Country:US
Mailing Address - Phone:210-875-1392
Mailing Address - Fax:
Practice Address - Street 1:1850 LOCKHILL SELMA RD STE 101B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1552
Practice Address - Country:US
Practice Address - Phone:210-695-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2025-03-06
Deactivation Date:2022-09-27
Deactivation Code:
Reactivation Date:2025-02-12
Provider Licenses
StateLicense IDTaxonomies
TX1076741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical