Provider Demographics
NPI:1073252482
Name:WANG, XIAOFENG (LPC)
Entity Type:Individual
Prefix:
First Name:XIAOFENG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 CHESTNUT ST UNIT 522
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5464
Mailing Address - Country:US
Mailing Address - Phone:215-909-2065
Mailing Address - Fax:
Practice Address - Street 1:4125 CHESTNUT ST UNIT 522
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5464
Practice Address - Country:US
Practice Address - Phone:215-909-2065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013730101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health