Provider Demographics
NPI:1194387837
Name:WONG, LENNIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LENNIE
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:LENNIE
Other - Middle Name:
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6860 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4242
Mailing Address - Country:US
Mailing Address - Phone:469-607-0076
Mailing Address - Fax:
Practice Address - Street 1:8951 CYPRESS WATERS BLVD STE 160
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4784
Practice Address - Country:US
Practice Address - Phone:469-607-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74117101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional