Provider Demographics
NPI:1003615394
Name:WONG, CHRISTOPHER HENRY (LCMHC, MSED)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HENRY
Last Name:WONG
Suffix:
Gender:
Credentials:LCMHC, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 KENNETT ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6137
Mailing Address - Country:US
Mailing Address - Phone:603-986-0203
Mailing Address - Fax:
Practice Address - Street 1:81 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-6044
Practice Address - Country:US
Practice Address - Phone:603-447-2453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health