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General NPI Number Information
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NPI Number | 1508055013
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Entity Type | Individual
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Provider Name | STEVEN HING WONG LPCC, LADAC
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Gender | Male
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Dates
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Enumeration Date | 10/20/2007
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 2309 RENARD PL SE STE 117
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4264
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Country | US
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Telephone | 505-401-5976
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Fax | 505-256-5171
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Provider Business Mailing Address
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Address Line | 424 BRYN MAWR DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2206
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Country | US
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Telephone | 505-401-5976
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Fax | 505-256-5171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0108411
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0108421
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License Number State | NM
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