Provider Demographics
NPI:1346959210
Name:WONG, KEVIN KWOCKYAU JR (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:KWOCKYAU
Last Name:WONG
Suffix:JR
Gender:M
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 DENAIN DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6000
Mailing Address - Country:US
Mailing Address - Phone:703-725-0550
Mailing Address - Fax:
Practice Address - Street 1:5866 S STAPLES ST STE 204
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3769
Practice Address - Country:US
Practice Address - Phone:361-446-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88118101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor