Healthcare Provider Details

I. General information

NPI: 1912345885
Provider Name (Legal Business Name): NEE VOON KHOO LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WALES KHOO LMHC

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6304 5TH AVE STE 1
BROOKLYN NY
11220-5284
US

IV. Provider business mailing address

6304 5TH AVE STE 1
BROOKLYN NY
11220-5284
US

V. Phone/Fax

Practice location:
  • Phone: 917-310-4867
  • Fax: 718-576-3391
Mailing address:
  • Phone: 917-310-4867
  • Fax: 718-576-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005309
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: