Healthcare Provider Details

I. General information

NPI: 1912976580
Provider Name (Legal Business Name): STEVEN ALFRED WONG PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/24/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 WISCONSIN AVE NW SUITE 300
WASHINGTON DC
20016
US

IV. Provider business mailing address

5100 WISCONSIN AVE NW SUITE 300
WASHINGTON DC
20016
US

V. Phone/Fax

Practice location:
  • Phone: 202-725-7237
  • Fax: 202-759-4455
Mailing address:
  • Phone: 202-725-7237
  • Fax: 202-364-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1000305
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: