MEDICARE: FANNY NG PSYCHOLOGY SERVICES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TP2701X	Group Psychotherapy Psychologist
2	103TH0100X	Health Service Psychologist
3	103TH0004X	Health Psychologist
4	101YM0800X	Mental Health Counselor
5	101YP2500X	Professional Counselor
6	103T00000X	Psychologist
7	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1023897808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FANNY NG PSYCHOLOGY SERVICES PLLC

Provider Business Mailing Address
First Line	:	26 COURT ST STE 409
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1134
Country	:	US
Telephone Number	:	646-960-3451
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 COURT ST STE 409
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1134
Country	:	US
Telephone Number	:	646-960-3451
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. FANNY NG
Credential	:	PH.D.
Telephone Number	:	929-245-6572

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	05/11/2026

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