Provider Demographics
NPI:1922256049
Name:WONG, KITCHING RHODA (LCSW)
Entity Type:Individual
Prefix:
First Name:KITCHING
Middle Name:RHODA
Last Name:WONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIT CHING
Other - Middle Name:RHODA
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7636 113TH ST
Mailing Address - Street 2:2N
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6513
Mailing Address - Country:US
Mailing Address - Phone:646-217-8728
Mailing Address - Fax:
Practice Address - Street 1:14015B SANFORD AVENUE
Practice Address - Street 2:2F
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-358-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0526191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9K591OtherMEDICARE PROVIDER NUMBER