MEDICARE: TIN LAM VONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1538806310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIN LAM VONG

Provider Business Mailing Address
First Line	:	946 BUSHWICK AVE APT F8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-3767
Country	:	US
Telephone Number	:	646-244-7834
Fax Number	:

Provider Business Practice Location Address
First Line	:	946 BUSHWICK AVE APT F8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-3767
Country	:	US
Telephone Number	:	646-244-7834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2022
Last Update Date	:	09/11/2025

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Directions to “ TIN LAM VONG ” Practice Location

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