Provider Demographics
NPI:1265148803
Name:WANG, HANWEN
Entity type:Individual
Prefix:
First Name:HANWEN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FRANCESCA CT
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3589
Mailing Address - Country:US
Mailing Address - Phone:201-896-7171
Mailing Address - Fax:
Practice Address - Street 1:101 HUDSON ST FL 21
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3929
Practice Address - Country:US
Practice Address - Phone:201-856-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006389101YM0800X
MALMHC10000645101YM0800X
NY013163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health