Provider Demographics
NPI:1225284110
Name:WONG, YANKAU JOSEPHINE (PHD, LCSW-R)
Entity Type:Individual
Prefix:DR
First Name:YANKAU
Middle Name:JOSEPHINE
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2042 BRAGG ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4020
Mailing Address - Country:US
Mailing Address - Phone:347-733-3374
Mailing Address - Fax:347-733-3374
Practice Address - Street 1:244 5TH AVE # 9C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7604
Practice Address - Country:US
Practice Address - Phone:347-733-3374
Practice Address - Fax:212-925-0327
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042400 (R)1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11798402OtherCAQH