Provider Demographics
NPI:1508055013
Name:WONG, STEVEN HING (LPCC, LADAC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:HING
Last Name:WONG
Suffix:
Gender:M
Credentials:LPCC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 BRYN MAWR DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2206
Mailing Address - Country:US
Mailing Address - Phone:505-401-5976
Mailing Address - Fax:505-256-5171
Practice Address - Street 1:2309 RENARD PL SE STE 117
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4264
Practice Address - Country:US
Practice Address - Phone:505-401-5976
Practice Address - Fax:505-256-5171
Is Sole Proprietor?:No
Enumeration Date:2007-10-20
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0108411101YA0400X
NM0108421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM65873874Medicaid